MSA Finalizes Updated Policy for Clinical Laboratory Fee Schedule Services

Posted on June 05, 2018

The Medical Services Administration (MSA) recently released a final policy to update Medicaid fee-for-service payment rates for laboratory services, which are based on the clinical lab fee schedule (CLFS). In response to comments received, the final policy clarifies that this policy does not apply to lab services provided by hospital outpatient departments or end-stage renal disease facilities. These entities are paid through the Medicaid outpatient prospective payment system (OPPS), which currently pays 50.9 percent of the Medicare OPPS rate.

Effective July 1, 2018, the MSA will update the Medicaid payment rates for laboratory services based on the 2018 Medicare CLFS payment rates. The MSA will update these rates at least annually, after the Centers for Medicare & Medicaid Services updates the Medicare CLFS each January. To establish the final Medicaid payment rate, the MSA subtracts any reduction required by law from 90 percent of the Medicare CLFS rate. Members with questions should contact Vickie Kunz at the MHA.

Tags: MSA, CLFS, final policy

Posted in: Member News

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