Wednesday, March 29, 2023

Very Brief Blog: New CLFS Released for April 2023; And Reminder about Full PLA Code Names Earlier

CMS releases its Clinical Lab Fee Schedule with quarterly updates, to accomodate new quarterly PLA codes.

CMS has released the listing for April 2023 - find it here (Q2-2023).

Short and Long Descriptors

CMS releases the CLFS with short code descriptors (about 20 letters) and a longer code descriptor which is kind of quirky, but can run up to about 10 words.   This is what we see in the Q2 April release.

Still on the CMS website is the Q1 January release.  This release of the CLFS had an extra column, at right, which seems to have the full PLA descriptors (however long).  It's nice to have these in Excel format.  It makes the January Q1 release a collector's item, since the PLA descriptors disappear by the April release.

Note that without too much work, you can ask ChatGPT for formula instructions how to take the CLFS (with columns for code, price, and descriptor) and merge it with the annual release of utilization data (with columns for code number, + number of services, and + total dollars paid).   I don't verify accuracy but I think I have done this in the cloud here.  I pulled columns for 2021 Part B # services and total payments into the existing 2023 CLFS fee schedule showing prices and code names.

click to enlarge. Importing UTIL and PAYMENTS into CLFS.

Transmittal CR12612

The PDF transmittal that announces the new fee schedule is CR12612, January 27, 2022, here.  

Summer meetings?

Last year, the transmittals announcing dates of the Summer CLFS meetings appeared around April 18, 2022, so if they match that, look for a mid April announcement.  Then you can plan summer vacations!