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Gapfill Pricing Inquiries

Guidance for CY 2016 final gapfill payment determinations.

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

Issue Date: February 29, 2012

Final Gapfill Payment Determinations - Calendar Year 2016

This file includes test codes and final prices, by locality, for clinical diagnostic laboratory tests that CMS determined should be priced by Medicare Administrative Contractors (MACs) for 2016 using the gapfilling methodology. The criteria and process for gapfilling are specified in 42 CFR 414.508(b). This final pricing file includes the national limitation amount and the individual locality prices.

 

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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.