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MLN Product (Revised): Clinical Laboratory Fee Schedule Annual Payment Determination Process

This revised product comprises Subregulatory Guidance for DMEPOS Suppliers, and its content is based on publicly available content at https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-G/section-414.506, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-G/section-414.508, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-G/section-414.509, https://www.ssa.gov/OP_Home/ssact/title18/1833.htm#act-1833-h-8,
https://www.ssa.gov/OP_Home/ssact/title18/1834.htm#act-1834-A-c, and https://www.ssa.gov/OP_Home/ssact/title18/1834.htm#act-1834-A-f .

CMS policy or operation subject matter experts also reviewed/cleared this product. This product educates vision providers about the Clinical Laboratory Fee Schedule Annual Payment Determination Process. This product also includes information on various CLFS topics such as the New, Reconsidered, & Revised HCPCS Code Process and Gapfill and includes links to applicable laws, regulations, and compliance information.

There are no substantive content updates for this revision.
The previous version of this product is currently posted on CMS website at
https://www.cms.gov/files/document/clinical-laboratory-fee-schedule-annual-payment-determination-process.pdf.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 16, 2023

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.