Medicare makes 2023 payment announcements for vaccine administration and labs

The Centers for Medicare & Medicaid Services (CMS) recently made two payment announcements relevant to many family physicians.

First, CMS announced updated amounts and codes for vaccine administration as part of the Medicare Part B fee schedule in calendar year 2023. This includes COVID-19 vaccine administration codes.

Second, CMS announced the calendar year 2023 Clinical Laboratory Fee Schedule (CLFS) final payment determinations. These payment determinations are relevant if you bill Medicare for lab services. If you want to ask CMS to reconsider payment amounts or the basis of payment, you must do so by Jan. 28. CMS will review reconsiderations at the 2023 CLFS Annual Public Meeting.

CMS also revealed new waived tests under the lab fee schedule. You can learn more about billing for Clinical Laboratory Improvement Amendments (CLIA) waived tests on the CMS website, including:

• Requirements,
• New tests approved by the Food and Drug Administration,
• Using modifier QW (CLIA waived test).

— Kent Moore, AAFP Senior Strategist for Physician Payment

Posted on Dec. 5, 2022