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Clinical Laboratory Fee Schedule

This revised Product comprises Subregulatory Guidance for the Clinical Laboratory Fee Schedule and its content is based on publicly available information at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched, https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/Clinical-Laboratory-Fee-Schedule-Files, https://www.cms.gov/Center/Provider-Type/Clinical-Labs-Center, and https://www.federalregister.gov/documents/2021/11/19/2021-23972/medicare-program-cy-2022-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part.

CMS policy or operation subject matter experts also reviewed/cleared this product.
This product educates providers about how Medicare pays for Clinical Diagnostic Laboratory Tests and Advanced Diagnostic Laboratory Tests under the Clinical Laboratory Fee Schedule.

Revisions to this Product include the 2023 end of PHE disclaimer and resource link (page 3).
The previous version of this Product is available to the public and currently posted on the CMS website at: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Clinical-Laboratory-Fee-Schedule-Fact-Sheet-ICN006818.pdf

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: May 12, 2023

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.