Tuesday, June 1, 2021

CMS Updates Summer Lab Pricing Agenda; Adds 44 Codes to Previous 53 Codes

 See my previous blog; in May, CMS released a 53-item agenda for the Annual Lab Meeting (ALM) for the Clinical Lab Fee Schedule (CLFS) to price new codes.  There are two meetings; a public comment meeting on June 24, and a professional advisory panel on July 28-29.  As before, public comments on how CMS should price any of the codes are due June 3 (see prior blog).

CMS has now released an updated agenda for the meetings.   See the CMS "Annual Public Meeting" web page here, and scroll down for CY2022 Codes, updated May 28. It's a zip file.

CMS has also posted an agenda (order of speakers) for June 24 - here.

CMS adds 44 new codes to the prior 53 codes.  One prior code is deleted.  Interestingly, one "reconsideration" code is added (reconsiderations were due last December).  15 added codes are Category 1 codes (80,000 series), 1 is an MAAA "M" code, and 29 are PLA codes.

CMS also updated the recommended comment submission template on May 24 - here.

Why CMS Expands the Lab Agenda in Late May, Every Year

What happens is this.   AMA votes on new Category I codes at the early May CPT meeting, and those codes (which will be published in September for the 2022 code book) are released to CMS in late May, for this agenda.   In addition, AMA took applications for second-quarter PLA codes around April 1, and AMA itself will publish those PLA codes its own AMA website around June 30.  But, AMA releases them early to CMS so they can be posted in late May for the late June meeting.

Bonus: AMA Deadlines

The next PLA deadlines are July 8 and October 7 (here).  The AMA has posted the next CPT meeting to be a "live" meeting September 30-October 2 in Chicago (here). The next CPT deadlines are June 30 and November 3 (here).