Travel Allowance for Specimen Collection Improper Place of Service (POS) Billing

Noridian has identified, along with the review entities, that many clinical laboratories have been incorrectly billing POS 81 for the travel allowance when a specimen has been collected in the home or nursing facility.

Travel Allowance

  • Travel allowance may be made in addition to a medically necessary specimen collection fee when the specimen is collected from a nursing home or homebound patient.
  • Independent laboratories must submit HCPCS code P9603 (per mile) or P9604 (flat rate) for each patient encounter for places of service:
    • 12 home
    • 13 assisted living facility
    • 14 group home
    • 31 nursing facility
    • 32 domiciliary care
    • 33 custodial care
    • 54 intermediate care facility
  • Claims for travel allowance submitted with place of service 81/independent lab will be denied.

Additional information is located at Laboratory.

 

            Last Updated Fri, 23 Jul 2021 17:24:05 +0000