Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.3.1
Hospital-Leased Laboratories
50.3.1 - Hospital-Leased Laboratories
(Rev. 1, 10-01-03)
B3-4110.1
A/B MACs (B) process claims from hospital laboratories that are leased by physicians
and independent laboratories.
Before processing claims for services furnished by a hospital laboratory department
operated on a lease or concession basis by a pathologist or by a nonphysician specialist
such as a biochemist (with a visiting pathologist or outside independent laboratory doing
the hospital’s tissue work), A/B MACs (B) must ascertain if the laboratory has been
approved by the RO.
Services furnished by a laboratory that does not meet the hospital laboratory conditions
of participation and is operated under a lease arrangement in a domestic emergency
hospital are covered only if they are emergency inpatient services payable under Part A.
Additional information concerning nonparticipating emergency hospital services is found
in Chapter 3.