CLFS Payment Toolkit
What You Need to Know
Once each year, usually in late June, CMS welcomes manufacturers of new lab tests to present information supporting a national CLFS payment rate for the test in the following year.
From start to finish, our meticulous process takes a minimum of 12 months. Beginning with a thorough evaluation of your test, we delve deep into understanding its intricacies, costs, and execution. Our expert team then determines an appropriate CLFS payment rate tailored to your specific test, while devising a compelling strategy to convince CMS. We leave no stone unturned in developing and effectively communicating our pricing decision to CMS, diligently following up to ensure that your test receives the favorable payment it deserves. At Gettysburg Healthcare Consulting, we are dedicated to being your trusted Medicare and Medicaid policy professionals, guiding you through every step of this intricate journey.
What do I need to do to get my test priced?
If you want to get CLFS payment for your new test, you’ll need to acquire a unique HCPCS code for your laboratory test. Once you’ve obtained the code, be prepared to explain the costs, resources, and clinical staff needed for your test, along with any other relevant data that can support the price. At Gettysburg Healthcare Consulting, our experienced team has successfully assisted numerous companies in obtaining pricing from Medicare. We are ready to provide the guidance and support you need to navigate this process effectively.
Our Expertise in CLFS Payment Shines
- Working with an experienced healthcare consultant with over 30 years of experience with the Medicare program provides you with a level of knowledge and skill unmatched in the industry.
- Our comprehensive understanding of AMA coding rules and requirements will help to avoid pitfalls and mistakes that might occur.
- Clients trust us to review their novel diagnostics and determine the best coding approach for their unique needs.