Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 50.5
Jurisdiction of Laboratory Claims
50.5 - Jurisdiction of Laboratory Claims
(Rev. 3071, Issued: 09-19-14, Effective: 12-22-14, Implementation: 12-22-14)
Jurisdiction of payment requests for laboratory services furnished by an independent
laboratory, except where indicated in §50.5.1 and §50.5.2, lies with the A/B MAC (B)
serving the area in which the laboratory test is performed. Jurisdiction is not affected by
whether or not the independent laboratory uses a central billing office and whether or not
the laboratory provides services to customers outside its A/B MAC (B)’s service area.
The location where the independent laboratory performed the test determines the
50.appropriate billing jurisdiction. Therefore, even if the sample originates in a different
jurisdiction from where the sample is being tested, the claim would still be filed in the
jurisdiction where the test was performed.
Claims filing jurisdiction for the specimen collection fee and travel allowance is also
determined by the location where the test was performed. When billed by an independent
lab, the specimen collection fee and travel allowance must be billed in conjunction with a
covered lab test. For more information about the specimen collection fee and travel
allowance, see §60.1 and §60.2, respectively.