Clinical Diagnostic Carrier and Laboratory Fee Schedule

**Overview**
This data package contains the clinical diagnostic laboratory fee schedule revised for January 2016. The update includes all changes identified in CR 9465. It also contains list of Medicare fee locality, which is a specific geographical area designated by Centers for Medicare and Medicaid Services (CMS) to receive the same fee schedule amount.

**Description**
This data package contains the Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. Payment is the lesser of the amount billed, the local fee for a geographic area, or a national limit. In accordance with the statute, the national limits are set at a percent of the median of all local fee schedule amounts for each laboratory test code. Each year, fees are updated for inflation based on the percentage change in the Consumer Price Index. However, legislation by Congress can modify the update to the fees. Co-payments and deductibles do not apply to services paid under the Medicare clinical laboratory fee schedule. Each year, new laboratory test codes are added to the clinical laboratory fee schedule and corresponding fees are developed in response to a public comment process. There are two main types of fee localities: Medicare Physicians Fee Schedule (MPFS) Localities and Reasonable Charge Localities. MPFS Localities are used to determine payments for codes that are carried on the Medicare Physician's Fee Schedule. Reasonable Charge localities are used to determine pricing for the types of procedures.

**Benefits**
- Medicare physician fee schedule (mpfs) is used by cms to reimburse physician services and it includes resource costs associated with physician work, practice expense and professional liability insurance.

**License Information**
The use of John Snow Labs datasets is free for personal and research purposes. For commercial use please subscribe to the [Data Library](https://www.johnsnowlabs.com/marketplace/) on John Snow Labs website. The subscription will allow you to use all John Snow Labs datasets and data packages for commercial purposes.

**Included Datasets**
- [Clinical Diagnostic Carrier and Locality Codes](https://www.johnsnowlabs.com/marketplace/clinical-diagnostic-carrier-and-locality-codes)
- A Medicare fee locality is a specific geographical area designated by CMS (Centers for Medicare and Medicaid Services) to receive the same fee schedule amount. Fee localities are typically divided along county lines, and may consist of a single county, several counties or maybe a statewide designation.
- [Clinical Diagnostic Laboratory Fee Schedule](https://www.johnsnowlabs.com/marketplace/clinical-diagnostic-laboratory-fee-schedule)
- This dataset contains the clinical diagnostic laboratory fee schedule revised for April 2023. The update includes all changes identified in Change Request (CR) 13082.

**Data Engineering Overview**
**We deliver high-quality data**
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搜集汇总

背景与挑战

背景概述

该数据集提供2016年修订的临床诊断实验室费用表，包含医疗保险费用区域划分和基于社会安全法案的实验室服务支付标准。数据经过三级质量审查，适用于医疗费用分析研究。