PAMA Lab Test Private Payor Rate Reporting
PAMA Lab Test Private Payor Rate Reporting What clinical labs need to know NOW to avoid future penalties. Protecting Access to Medicare Act (PAMA) requires applicable laboratories to report private payer rates for clinical laboratory services to the CMS; the data is necessary to calculate Medicare reimbursement rates for tests on the clinical laboratory fee schedule. In 2018, CMS included hospital “outreach” laboratories which submit claims for non-patient services to the list of entities that