New Stark Law rules create safe harbors to promote value-based care, telehealth
A pair of Final Rules issued recently by CMS and the OIG establishes new safe harbors aimed to promote value-based care, while also modifying some of the existing safe harbors. CMS said the intent behind the new rules, which were first proposed in 2019, is to allow...Key Industry Terms in Laboratory Billing
ACO Accountable Care Organization: A model for patient population management APC Ambulatory Patient Classifications: The government’s method for paying for outpatient services for the Medicare program. APM Alternative Payment Model: These are the new payment models...
CMS clarifies rules for U0005 COVID add-on payment
When CMS announced its intent to reduce payments for high-throughput COVID-19 tests next year while offering providers a path to be made whole if they met new turnaround time targets, several questions arose concerning how the agency intended to monitor its new...
MolDX removes coverage for BioFire, GenMark respiratory panels
As of Oct. 1, MOLDX has updated their LCDs/Billing and Coding Articles for the Multiplex Nucleic Amplified Tests for Respiratory Panels to no longer cover the PLA codes 0098-0099U, U100U, and 0115U. These PLA codes represent respiratory panels using BioFire® or...
Lighthouse Acquires MJB Lab Consulting, Expanding Medical Leadership Services