Payment Requirements for Test Procedures (HCPCS Codes 64585, 64590 and 64595)

40.2.2 – Payment Requirements for Test Procedures (HCPCS Codes 64585, 64590 and 64595) (Rev. 2998, Issued: 07-25-14, Effective: Upon implementation of ICD-10; 01-01-12 - ASC X12, Implementation: 08-25-2014 - ASC X12; Upon Implementation of ICD-10) Payment is as follows: • Hospital outpatient departments – OPPS • Critical access hospital (CAH) - Reasonable cost • Comprehensive outpatient rehabilitation facility - Medicare physician fee schedule (MPFS) • Rural health clinics/federally qualified health centers (RHCs/FQHCs) - All inclusive rate, professional component only. The technical component is outside the scope of the RHC/FQHC benefit. Therefore, the provider of that technical service bills their A/B MAC (B) using the ASC X12 837 professional claim format or Form CMS-1500 and payment is made under the MPFS. For provider-based RHCs/FQHCs payment for the technical component is made as indicated above based on the type of provider the RHC/FQHC is based with. Deductible and coinsurance apply.