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Medicare Laboratory Payment Policy: Now and in the Future
such inpatient care, and meets the detailed criteria contained in 42 C.F.R., Part 412.92.
Literally, at once. Medically, this refers to tests that are expedited for immediate processing and return of results.
Sustainable growth rate:
The target rate of expenditure growth set by the SGR system incorporated in the Medicare fee schedule for physicians.
Sustainable growth rate system:
A revision to the volume performance standard system, enacted as part of the BBA of 1997, that serves as the mechanism for setting fee updates for the Medicare fee schedule. It uses a single conversion factor and bases target rates of growth on growth of gross domestic product and other factors.
Technical laboratory personnel:
Highly trained or technically certified individuals capable of advanced processing or evaluation of laboratory tests.
The amount of time that elapses from the initiation of a laboratory test until results from that test are reported to the clinician or patient.
Charging individually for tests that should be billed as a panel at a lower aggregate rate.
The year-to-year increase in the Medicare base payment amounts for providers such as PPS hospitals and dialysis facilities and in the target amounts for PPS-excluded hospitals and units.
Surgical puncture of a vein, generally to draw a blood sample for testing.
A laboratory test defined by CLIA standards that can be conducted with minimal chance of error.
This list is based on glossaries included in the following reports:
Health Care Financing Administration. Health Standards and Quality Bureau. 1994. Laboratory Surveyor Training Manual. Washington, DC.
Kazon, P.M. 1999. Doing Business with Medicare: A Policy Guide for Clinical Laboratory Testing, Washington, DC: Washington G-2 Reports.
U.S. Congress, MedPAC, 1999. Report to the Congress: Medicare Payment Policy. Washington, DC: Medicare Payment Advisory Commission.
U.S. Congress, Office of Technology Assessment. 1986. Payment for Physician Services: Strategies for Medicare. OTA-H-294. Washington, DC: U.S. Government Printing Office.