ASCP Scores Major Victory with CMS on Laboratory Date of Service Policy

Publication Date: Nov 12, 2019

The Centers for Medicare & Medicaid Services (CMS) announced it has adopted ASCP’s recommendations on its Laboratory Date of Service (DOS) Policy. The Agency had floated several proposals that would undermine the Laboratory DOS exemption for molecular pathology services, which allows the laboratory (rather than the hospital) to bill for the molecular pathology services they provide to patients after discharge from an outpatient encounter. In this year’s Medicare Outpatient Prospective Payment System Final Rule, released November 1, CMS concurred with ASCP’s concerns that its proposals could negatively affect patient access to molecular pathology testing services and would create significant administrative burdens for hospitals and clinical laboratories.

In siding with ASCP’s recommendations, CMS backed away from its proposal to require the ordering physician to determine if molecular pathology services ordered for a recently discharged patient should be billed by the hospital or by the performing laboratory. CMS also followed ASCP’s recommendation not to restrict laboratories (rather than the hospital) to bill only for those molecular pathology services that are classified by the Agency as Advanced Diagnostic Laboratory Tests.

ASCP also recommended that CMS continue to allow blood banks for diagnostic services provided patients recently discharged from an outpatient encounter. Click here for a copy of ASCP’s comment letter to CMS.

Other articles in the November 2019 ePolicy News: