PAMA Reporting for Labs
The Protecting Access to Medicare Act of 2014 (PAMA) revised the payment methodology for clinical diagnostic laboratory tests paid under the Medicare Clinical Laboratory Fee Schedule (CLFS). Under PAMA, CMS will base 2023 clinical laboratory fee schedule payment rates on private payer rates as reported by applicable labs.
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CMS Delays PAMA
In January 2020, CMS delayed the PAMA data reporting period from 2020 to 2021. Applicable laboratories were given an additional year to report final payment data collected during the first six months of 2019. In March 2020, the Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law. The CARES Act included two provisions that impacted the PAMA program. First, it provided an additional one-year delay from reporting requirements under PAMA; second, it delayed cuts to the clinical laboratory fee schedule by one year. The specifics related to these provisions are pending final publication by CMS.