Medicare Part B CLFS: Revised Information for Laboratories on Collecting & Reporting Data for the Private Payor Rate-Based Payment System - Revised

MLN Matters Number: SE19006 Revised
Article Release Date: November 4, 2021

Note: CMS revised this article to note that for CDLTs that aren’t ADLTs, the data reporting is delayed by one year and must now be reported from January 1, 2022, through March 31, 2022 (previously January 1, 2021, through March 31, 2021). All references to the 2021 data reporting period have been changed to 2022. In addition, CMS included information about the Online Data Collection System. You’ll find substantive content updates in dark red font (see pages 2,13-15 and 21-24). There are no other changes to the substance of the article.

SE 19006 will help laboratories meet the requirements under Section 1834A of the Social Security Act (the Act) for the Medicare Part B Clinical Laboratory Fee Schedule (CLFS). It covers:

  • Clarifications for deciding whether a hospital outreach laboratory meets the requirements to be an “applicable laboratory”
  • Applicable information (private payor rate data) that you must collect and report to us
  • The entity responsible for reporting applicable information to us
  • The data collection and reporting periods
  • Information about our online data collection system
  • Our schedule for implementing the next private payor-rate based CLFS update
  • Information about the condensed data reporting option for reporting entities

View the complete CMS Medicare Learning Network (MLN) Matters (SE)19006.


            Last Updated Thu, 11 Nov 2021 18:49:25 +0000