The Centers for Medicare & Medicaid Services (CMS) announced 18 new laboratory codes for Proprietary Laboratory Analysis (PLA) along with one additional new code. These codes will be effective Oct. 1, 2023.
The new codes, listed here, are priced by Medicare Administrative Contractors (MACs) where applicable until they are nationally priced and undergo the Clinical Laboratory Fee Schedule annual payment determination process. MACs will only price PLA codes for laboratories within their jurisdictions.
CMS noted that MACs will not search their files to retract payment or retroactively pay claims. They will, however, adjust claims that are brought to their attention.