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Medicare and Medicaid Payment Policies

Part B Fee Schedule

On this page you will find information about CPI increases, travel allowance, rebasing fee schedule, inherent reasonableness, and Advance Beneficiary Notices (ABNs).

04/17/2013
AAB/NILA to Senate Finance Committee: No More Part B CLFS Cuts!

04/10/2013
President's 2014 Budget Proposes to Cut Part B CLFS by 14% from 2016-2023

04/10/2013
Labs May Be Excluded as EHR Donors

03/20/2013
CMS Increases Part B Trip Fee Payments

12/06/2012
OIG Recommendations on Medicare
Part B Lab Cuts

12/05/2012
CMS Transmittal Updating the Part B Clinical Lab Fee Schedule for 2013

11/30/2012
CLC Letters to Congress - Protect Access to Clinical Lab Services for Medicare Beneficiaries, Oppose Reductions to the CLFS

09/05/2012
CMS Preliminary Payment Determinations published late August 2012

07/20/2012
Community Laboratories Needed to Press Offensive Against Laboratory Fee Schedule Cuts

02/17/2012
Congress Includes Lab Cuts in Physician Pay Fix

02/16/2012
Alert! Lab Cuts Being Considered to Pay for Physician Pay Fix

Tweet your Senators, Representatives

02/16/2012
IMMEDIATE ATTENTION NEEDED: Congress Proposes to Cut Labs

12/23/2011
Medicare Physician Fee Schedule, Final Rule

12/02/2011
2012 Physician Fee Schedule Final Rule

11/01/2011
2011 Version of Advance Beneficiary Notice of Noncoverage Must Be Used Beginning Sunday, January 1, 2012

08/02/2011
Text of Debt Ceiling Agreement

12/01/2010
Part B Clinical Laboratory Fee Schedule (CLFS) to Decrease by 1.75% on January 1, 2011

12/29/2009
Standard Mileage Rate Drops To 50 Cents

07/16/2009
Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2010; Proposed Rule, Federal Register, July 13, 2009

07/11/2009
OIG - Variation in the Clinical Laboratory Fee Schedule

03/11/09 - Negotiated Rulemaking
Medicare Clinical Diagnostic Laboratory Fee Schedule Modernization Act, HR 1452

12/19/08 - CPI Increase
CMS Transmittal announcing the 4.5% CPI increase to the 2009 Part B fee schedule

09/17/08 - Travel Allowance
8 Cent Increase to Trip Fee to be Implemented October 6, 2008

08/1/08 - Rebase Fee Schedule
HR 6761, A Bill to Rebase the Part B Clinical Laboratory Fee Schedule

05/30/08 - Travel Allowance
Travel Allowance Increase

Advanced Beneficiary Notices (ABNs)

2008

CMS Manual System, Pub 100-04 Medicare Claims Processing, Transmittal 1587, Subject: Revised Form CMS-R-131 Advance Beneficiary Notice of Noncoverage September 2008

ABN Information June 2008

2002

Federal Register - February 19, 2002

Revisions to the Draft ABN Based on Comments Received

Forms

ABN Form No. CMS-R-131-L (English) for lab services
ABN Form No. CMS-R-131-L (Spanish) for lab services
ABN Form No. CMS-R-131-G (English) for all services
ABN Form No. CMS-R-131-G (Spanish) for all services

Supporting Statement and Comments & Responses

2006 Update to Medicare's Part B Clinical Lab Fee Schedule - Part B Fee Schedule

Medicare Clinical Laboratory Fee Schedule Improvement Act of 2006 (Introduced in House) HR 5369 - Rebasing Fee Schedule

05/15 /06 - Part Be Fee Schedule
Hold On Medicare Payments

12/13/05
Medicare Program; Application of Inherent Reasonableness Payment Policy to Medicare Part B Services (Other Than Physician Services), Federal Register, December 13, 2005

2001-2002 Negotiated Rulemaking

Final Rule, Federal Register - November 23, 2001
PM AB-02-129, September 27, 2002 - instructions to implement the remaining administrative policies for clinical diagnostic laboratory services under Medicare Part B specified in the final negotiated rulemaking regulation.
PM AB-02-110, July 31, 2002 - includes national coverage decisions for clinical diagnostic laboratory service
PM AB-02-087, June 26, 2002 - announces the delay in the implementation of the editing for the National Coverage Decisions to January 1, 2003, for dates of service on or after November 25, 2002.
PM AB-02-030, March 2002 - implemented certain administrative policies from the final rule effective February 23, 2002.

03/10/00 - Negotiated Rulemaking
Medicare Program; Negotiated Rulemaking: Coverage and Administrative Polices for Clinical Diagnostic Laboratory Services
This link will take you to the table of contents for the March 10, 2000, Federal Register. Scroll down to Health Care Financing Administration in this table of contents to find this proposed rule.