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Elizabeth M. Whitehorn, Director

Provider Notice issued 09/09/08

Change in Reimbursement for Automated Laboratory Services

To:​

Participating Hospitals, Laboratories and Physicians​

​Date: ​September 9, 2008
​Re:

Change in Reimbursement for Automated Laboratory Services

Effective with dates of service October 1, 2008, and after, the department will no longer reimburse providers for the professional component on automated lab services.  Providers will still receive reimbursement for the technical component.  The lab services affected by this change are within the CPT code series 80000 through 85999.  The department’s physician fee schedule will be updated prior to October 1st to reflect the new reimbursement rates for automated lab services.  Automated lab procedure codes will be identified on the fee schedule with Note "N".

Claims should be submitted for the technical component of these codes only.  Claims submitted with modifier "26" will be rejected. 

Your participation in our programs is greatly appreciated.  Questions regarding this notice may be directed to the Bureau of Comprehensive Health Services at 1-877-782-5565.

Theresa Eagleson, Administrator

Division of Medical Programs