Monday, June 30, 2025

Brief Blog: Billing for G0452 (Molecular Pathology Interpretation) in 2023

CMS recently released Part B billing records for doctors and labotatories, for CY2023 (here).

I pulled the records for G0452, Molecular Pathology Interpretation (about $50).

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Medicare Part B paid for 152,659 services of G0452,  for a total of $7.2M dollars allowed.

The top-billing provider was a laboratory in Arizona, with 12,234 services or 8% of the total.

Of the top-20 billing entities, 2 were registered as clinical laboratories.  Of the other 18, 5 had MD-PhD degrees and the rest MD.   Most of the MDs were facility-based (e.g. in a pathology service or department or practice that is hospital-based).

19 providers billed for >1000 cases of G0452.  Of 680 total providers, the top 20 had 32% of G0452 revenue.  Click to enlarge.

Click to enlarge