PAMA Regulations- Data Reporting Period is Now Open

The data reporting period is now open. Private Payer data are due to CMS by March 31, 2017. Under the final rule, laboratories, including physician office laboratories, are required to report private payer rate and volume data if they:

  • have more than $12,500 in Medicare revenues from laboratory services on the CLFS and
  • they receive more than 50 percent of their Medicare revenues from laboratory and physician services during a data collection period.

Laboratories will provide private payer data collected from January 1, 2016 through June 30, 2016 and report it to CMS by March 31, 2017. The new Medicare CLFS rates (based on weighted median private payer rates) will be posted in November 2017 and will be effective on January 1, 2018.

See the full CMS page below:

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/PAMA-Regulations.html