This is a companion article to the feature, “Getting Ahead of PAMA.”

Laboratories, including physician office laboratories, are required to report private payor rates and volume data if they meet both of the following criteria.1

  • The lab derives more than $12,500 in Medicare revenues annually from laboratory services listed on the CLFS.
  • The lab receives more than 50% of its Medicare revenues during a data collection period from laboratory and physician services.

Laboratories meeting these criteria must collect their private payor data for the period from January 1, 2019, through June 30, 2019, and must report it to CMS no later than March 31, 2020. For further information about PAMA data collection requirements, visit the Centers for Medicare and Medicaid Services.

Reference

1. PAMA Regulations [online]. Baltimore, Md: Centers for Medicare and Medicaid Services, 2019. Available at: www.cms.gov/medicare/medicare-fee-for-service-payment/clinicallabfeesched/pama-regulations.html.  Accessed February 13, 2019.