Recent Congressional Actions Seek to Address Medicare LCD, MA, and NSA Enforcement Reforms
A suite of bills recently introduced in Congress seek to address issues underlying Medicare local coverage determinations (LCDs), Medicare Advantage...
1 min read
The Centers for Medicare & Medicaid Services (CMS) will now allow laboratories to bill the laboratory specimen collection travel allowance to the 10th of a mile.
Starting Jan. 1, 2026, HCPCS code P9603, which applies to the travel allowance for specimen collection from eligible Medicare beneficiaries, may be calculated to the 10th of a mile “to provide more accurate reporting and reimbursement for certain travel distances,” CMS announced on July 31. Medicare Administrative Contractors will update their claims processing systems to facilitate implementation of this change request.
The per-mile travel allowance applies:
- when roundtrip travel to one location exceeds 20 eligible miles for one or more patients; and
- when travel is to more than one location, regardless of the number of miles traveled.
When billing for the travel allowance, for trips totaling less than a mile, a 0 should be included before the decimal (0.9). For trips totaling up to 100 eligible miles, mileage should be rounded up to the nearest 10th of a mile. For trips totaling 100 eligible miles or more, mileage should be rounded up to the next whole number mile.
Source:
Medicare MBI Changes: What Providers Need to Know to Prevent Claim Denials
TELCOR has noticed an increase in “missing/incomplete/invalid patient identifier” denials from Medicare.
