For the Week of January 23, 2017

Which Pap Test codes are included in the Medicare national payment rate?

As required by law, payment for a cervical or vaginal smear test (Pap smear) must be the lesser of the local fee or the national limitation amount (NLA) but not less than a national +minimum payment amount, which for 2017 is $14.49. Payment for these tests may not exceed the actual charge.

The national minimum payment amount applies to the following codes: 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88164, 88165, 88166, 88167, 88174, 88175, G0123, G0143, G0144, G0145, G0147, G0148, G0476, and P3000.