Sec. 7 AAC 145.460 - Laboratory services payment

ยง 7 AAC 145.460. Laboratory services payment

(a) The department will pay for laboratory services provided in state by an independent laboratory in accordance with 7 AAC 145.020, at the rate established for Medicare in 42 C.F.R. 405.515, adopted by reference in 7 AAC 160.900; laboratory services for which no rate is established will be paid at a rate established under 7 AAC 145.050(e).

(b) The department will pay for laboratory services provided out of state by an independent laboratory in accordance with 7 AAC 145.025, not to exceed the maximum amount identified in (a) of this section.

(c) Routine collection of venous blood by venipuncture performed with a surgical or laboratory procedure is considered incidental to that procedure and is not paid separately.

(d) The department will not pay for the handling or conveyance of a specimen for transfer from the physician's office or from the patient in other than the physician's office to a laboratory. These procedures are considered incidental to the other services performed for the patient.

(e) For state fiscal year 2020, payment rates for laboratory services will be 95 percent of the payment rates established in (a) of this section starting on the later date of August 1, 2019, or after a 30 day notice to the providers, for providers who are not enrolled in the Medicaid Management Information System (MMIS) as the provider types or provider specialties listed in 7 AAC 145.050(c) and who are identified as the rendering provider on the claims submitted to the Medicaid Management Information System (MMIS).

(Eff. 2/1/2010, Register 193; am 7/1/2019, Register 231, January 2019)

Authority:AS 47.05.010

AS 47.07.030

AS 47.07.040

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