The Centers for Medicare & Medicaid Services (CMS) recently announced PAMA reporting has been further delayed, making the new reporting period is Jan. 1, 2022 through March 31, 2022. The data collection period will remain as Jan. 1, 2019 through March 31, 2019. Additionally, there is a 0.0% reduction to the Clinical Laboratory Fee Schedule (CLFS) for CY 2021.
The Silver Lining
A delay in reimbursement cuts. For 2021, the laboratory industry was expecting CLFS cuts of up to 15%, so 0% reduction in 2021 is a welcome one-year reprieve.
The data collection period for remains the same. Keeping the same data collection period provides some advantages for the laboratory:
- Private payors have continued to implement further reductions in payment for laboratory testing in 2020.
- Example: the UnitedHealthcare Reference Laboratory Protocol, effective May 1, 2020, which allowed hospital laboratories to perform testing for UHC patients, but only if they accepted a reduced fee schedule.
- Some private insurance companies have fee schedules tied to the CLFS, using 2019 data keeps reported revenue at 2019 rates, which were higher than 2020 rates.
Find Out More
More information is available on the CMS website linked here.