Friday, December 23, 2016

CMS Releases Final Lab Fee Schedule for CY2017

CMS released the CY2017 CLFS pricelist on December 22, 2016.

  • The home page for CLFS for recent years, including CY2017, is here.
  • The newly released CLFS for CY2017 is here.

  • I also provide a cloud copy of the December CMS spreadsheet, except, I have added a "column D" which shows test name much closer to the code column and price column. 

Also released on December 22 was Transmittal R3682CP/CR9909, discussing the new fee schedule, here.  This transmittal includes "mapping information" for crosswalks between new codes and older codes, e.g. "New code 84410 is priced at the same rate as the sum of codes 84402 and 84403."

Nerd Note.

In late November, CMS released, but withdrew, a CY2017 Clinical Laboratory Fee Schedule.

Now, in late December, CMS released a minimally updated version of the CY2017 CLFS.   The December 22 release lacks about five QW entries (CLIA waived entries) that were found in the retracted November version.  When a test has a CLIA Waived version, CMS lists the CPT code twice, at the same price, with the second line carrying a QW modifier.