When ordering laboratory tests for patients who are enrolled in Medicare or other federally funded insurance programs, reimbursement may be limited to:
Only tests that are medically necessary for the diagnosis or treatment of the patient. Federally funded programs may not pay for non-FDA approved tests or tests considered research or investigational use only.
Medicare does not pay for many tests when ordered as screening. Screening test coverage is limited to those tests included in Preventive Services at the defined frequencies.
If there is reason to believe Medicare will not pay for a test, the patient must be informed via the Advance Beneficiary Notice (ABN) of their financial responsibility if Medicare denies payment.
CCL and client customized panels should be ordered only when every component of the customized panel is medically necessary
The CCL requisition form is designed to capture accurate information as required by federal or private health care programs.