Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 30.2
Deductible and Coinsurance Application for Laboratory Tests
30.2 - Deductible and Coinsurance Application for Laboratory Tests
(Rev. 2581, Issued: 11-02-12, Effective: 04-01-13, Implementation: 04-01-13)
Neither the annual cash deductible nor the 20 percent coinsurance apply to:
•
Clinical laboratory tests performed by a physician, laboratory, or other entity paid on an assigned basis;
•
Specimen collection fees; or
•
Travel allowance related to laboratory tests (e.g., collecting specimen).
Codes on the physician fee schedule are generally subject to the Part B deductible and coinsurance, although
exceptions may be noted for a given code in the MPFS or through formal Medicare instructions such as
temporary instructions and requirements for specific services noted in this manual.
Any laboratory code paid at reasonable charge is subject to the Part B deductible and coinsurance, unless
otherwise specified in the description of coverage and payment rules.