Clinical Laboratory Fee Schedule

Clinical Laboratory Transmittals

The list below shows the transmittals that are directed to the Clinical Laboratory provider community, but the list may not include all instructions for which Clinical Laboratory providers are responsible. For a list of all instructions, view the Transmittals web page under Regulations and Guidance.

CR # Release Date Subject MLN Article #
5362 12/08/2006 2007 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment MM5362
5419 12/22/2006 Provider Migration N/A
6985 06/18/2010 Additional Healthcare Common Procedure Coding System (HCPCS) Codes Subject to Clinical Laboratory Improvement Amendments (CLIA) Edits MM6985
7057 07/16/2010 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2010 MM7057
7140 09/24/2010 Clarification on the Effective Date on the Procedure Status Indicator for Common Procedural Terminology (CPT) Code 80101 MM7140
7266 03/28/2011 New Waived Tests N/A
6042 07/29/2008 Medicare Improvements for Patients and Providers Act of 2008- Legislative Change Concerning Independent Laboratory Billing for the Technical Component of Physician Pathology Services. MM6042
7526 09/16/2011 Clinical Laboratory Fee Schedule-Medicare Travel Allowance Fees for Collection of Specimens MM7526
5926 02/29/2008 Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits MM5926
7061 10/29/2010 Edit to Deny Payment to Physicians and Other Suppliers for the Technical Component (TC) of Pathology Services Furnished on Same Date as Inpatient and Outpatient Services and Implements New Messages N/A
6908 10/28/2010 Implementation of Section 2902 of the Patient Protection and Affordable Care Act (the Affordable Care Act) for Indian Health Service (IHS) Part B Services and All Inclusive Rate (AIR) Billing for Return Visits N/A
7184 11/05/2010 New Waived Tests N/A
6786 04/22/2011 Screening for the Human Immunodeficiency Virus (HIV) Infection N/A
7325 04/22/2011 Adjudication of Laboratory Tests that are Excluded from Clinical Laboratory Improvement Amendment (CLIA) Edits N/A
6991 11/24/2010 Calendar Year (CY) 2011 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment MM6991
7239 12/03/2010 Clinical Laboratory Fee Schedule- Medicare Travel Allowance Fees for Collection of Specimens MM7239
5493 02/02/2007 Outpatient Clinical Laboratory Tests Furnished by Hospitals With Fewer Than 50 Beds in Qualified Rural Areas MM5493
5514 03/09/2007 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2007 N/A
7566 10/21/2011 New Waived Tests MM7566
6657 12/23/2009 Calendar Year (CY) 2010 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment MM6657
7621 11/04/2011 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2012 N/A
7413 05/20/2011 Affordable Care Act Section 3113 Laboratory Demonstration for Certain Complex Diagnostic Tests N/A
7413 05/20/2011 Affordable Care Act Section 3113 Laboratory Demonstration for Certain Complex Diagnostic Tests N/A
7435 06/17/2011 New Waived Tests MM7435
7621 10/21/2011 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2012 N/A
6084 06/26/2008 Laboratory National Coverage Determination (NCD) Edit Software Changes for July 2008 MM6084
6084 06/06/2008 Laboratory National Coverage Determination (NCD) Edit Software Changes for July 2008 MM6084
5856 01/18/2008 Revision to Instructions Relating to Compliance Standards for Independent Diagnostic Testing Facilities (IDTFs) MM5856
5813 12/20/2007 2008 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment MM5813
5285 03/21/2007 Provider/Supplier Enrollment Approval Letters N/A
5675 07/13/2007 Laboratory and Radiology: Adjustment to Common Working File (CWF) Duplicate Claim Edit for the Technical Component (TC) of Radiology and Pathology Laboratory Services Provided to Hospital Patients N/A
5597 07/13/2007 IOM Pub. 100-09, Chapters 3- Provider Inquiries and Chapter6- Provider Customer Service Program Updates N/A
5597 06/29/2007 IOM Pub 100-09, Chapters 3, Provider Inquiries and Chapter 6 - Provider Customer Service Program Updates MM5597
5672 07/13/2007 Implementation of New Compliance Standards for Independent Diagnostic Testing Facilities (IDTFs) N/A
5772 02/01/2008 Implementation of Laboratory Competitive Bidding Demonstration MM5772
5359 03/19/2008 Laboratory Competitive Bidding Demonstration (Second Phase of Implementation) N/A
5874 02/15/2008 Clinical Lab: New Automated Test for the AMCC Panel Payment Algorithm MM5874
5913 03/14/2008 New Waived Tests MM5913
5961 04/04/2008 Extension of Reasonable Cost Payment for Clinical Lab Tests Furnished by Hospitals with Fewer Than 50 Beds in Qualified Rural Areas N/A
5987 04/11/2008 Clinical Laboratory Fee Schedule - Implementation of Section 113 of the Medicare, Medicaid and State Children's Health Insurance Program (MMSCHIP) Extension Act of 2007 MM5987
6812 02/05/2010 Healthcare Common Procedure Coding System Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments Edits MM6812
6787 02/12/2010 Revised Clinical Laboratory Fee Schedule and ZIP Code file to include Kansas Payment Locality Structure MM6787
6852 03/19/2010 Clinical Laboratory Fee Schedule- Special instructions for Specific Test Codes (CPT Code 80100, CPT Code 80101, CPT Code 80101QW, G0430, G0430QW, and G0431QW) MM6852
6964 04/30/2010 Changes to the Laboratory National Coverage Determination Edit Software MM6964
6864 03/19/2010 Clinical Laboratory Fee Schedule- Medicare Travel Allowance Fees for Collection of Specimens MM6864
7654 12/09/2011 Calendar Year (CY) 2012 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment MM7654
7671 12/16/2011 Summary of Policies in the CY 2012 Medicare Physician Fee Schedule (MPFS) Final Rule and the Telehealth Originating Site Facility Fee Payment Amount MM7671
5815 05/16/2008 New Chapter for Independent Diagnostic Testing Facilities (IDTF) MM5815
5996 05/30/2008 Clinical Laboratory Fee Schedule-Medicare Travel Allowance Fees for Collection of Specimens MM5996
6021 05/30/2008 Clinical Laboratory Fee Schedule - New Waived Tests MM6021
6018 05/23/2008 Date of Service (DOS) for Clinical Laboratory and Pathology Specimens MM6018
7294 01/21/2011 Medicare and Medicaid Extenders Act of 2010 (MMEA) Extension of Reasonable Cost Payment for Clinical Lab Tests Furnished by Hospitals with Fewer Than 50 Beds in Qualified Rural Areas MM7294
7278 01/28/2011 Affordable Care Act - Section 3113 -Laboratory Demonstration for Certain Complex Diagnostic Tests N/A
7278 01/28/2011 Affordable Care Act - Section 3113 - Laboratory Demonstration for Certain Complex Diagnostic Tests N/A
7413 07/15/2011 Affordable Care Act - Section 3113 - Laboratory Demonstration for Certain Complex Diagnostic Tests (This CR Fully Rescinds and Replaces CR 7278) N/A
7313 02/11/2011 Clinical Laboratory Fee Schedule -Medicare Travel Allowance Fees for Collection of Specimens MM7313
7266 02/11/2011 New Waived Tests MM7266
7277 02/11/2011 Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits MM7277
7513 07/22/2011 Additional Healthcare Common Procedure Coding System (HCPCS) Codes Subject to Clinical Laboratory Improvement Amendments (CLIA) Edits MM7513
7507 07/22/2011 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2011 MM7507
5347 04/19/2007 Common Working File (CWF) Duplicate Claim Edit for the Technical Component (TC) of Radiology and Pathology Laboratory Services Provided to Hospital Patients N/A
6060 06/20/2008 New Waived Tests MM6060
7671 01/18/2012 Summary of Policies in the CY 2012 Medicare Physician Fee Schedule (MPFS) Final Rule and the Telehealth Originating Site Facility Fee Payment Amount N/A
7516 07/29/2011 Affordable Care Act - Section 3113 - Laboratory Demonstration for Certain Complex Diagnostic Tests (This CR fully Rescinds and Replaces CR 7413) MM7516
7516 07/29/2011 Affordable Care Act - Section 3113 - Laboratory Demonstration for Certain Complex Diagnostic Tests (This CR fully Rescinds and Replaces CR 7413) MM7516
6088 07/07/2008 Pathology Services: Notification of the Sunset for the Payment of Physician Pathology Services for Independent Laboratories MM6088
5573 08/17/2007 Date of Service for Laboratory Specimens MM5573
5600 05/18/2007 New Waived Tests N/A
7278 03/10/2011 Affordable Care Act-Section 3113- Laboratory Demonstration for Certain Complex Diagnostic Tests N/A
7278 03/10/2011 Affordable Care Act-Section 3113- Laboratory Demonstration for Certain Complex Diagnostic Tests N/A
7610 01/26/2012 Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs (ICD-10) MM7610
7610 01/26/2012 Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs (ICD-10) MM7610
7694 2012-02-03 New Waived Tests MM7694
7766 2012-04-06 Clinical Laboratory Fee Schedule - New Waived Tests MM7766
7795 2012-04-06 New Waived Tests MM7795
7778 2012-04-06 Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits MM7778
7815 2012-04-27 FISS update for Clinical Laboratory Fee Schedule upload to include Kansas Payment Locality Structure MM7815
7610 2012-05-23 Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) to Prevent STIs (ICD-10) N/A
7868 2012-07-20 New Waived Tests MM7868