CMS Extends Reasonable Cost Payment for Clinical Lab Tests for Small Hospitals in Qualified Rural Areas

The Centers for Medicare and Medicaid Services has extended the reasonable cost payment for clinical laboratory tests performed by hospitals with fewer than 50 beds in qualified rural areas as part of their outpatient services for the cost reporting periods beginning July 1, 2010 through June 30, 2011, according to CMS Transmittal 1940.

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The extension of the act could affect some hospitals’ services performed as late as June 30, 2012, according to the transmittal. The Medicaid ZIP Code File will be used to determine qualified rural areas. Contractors shall calculate payment on a reasonable cost basis for outpatient clinical laboratory services from qualified hospital and not hold beneficiaries responsible for any deductible, coinsurance or other cost-sharing amount.

A provider education article will be released through MLN Matters and the corresponding listserv.

Read the CMS transmittal on reasonable cost payment for clinical lab tests at small rural hospitals (pdf).

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