Providers who perform Laboratory and/or Medical Imaging Services

May 5, 2011

This is a follow up communication to a message that was sent out in early March.

Effective April 4, 2011, providers who perform Laboratory and/or Medical Imaging Services will see claim adjustments on their remittance statements for these services provided 9/1/2010 and later. This is because in most cases, the rate paid was higher than the correct rate.

The entire original payment will be reversed and credited. On a later remittance statement, an adjustment claim will be created and will pay at the lower rate.

The list of codes affected is available online at the Department’s Rate Setting Unit web page. To find the rates, please search under Section 55 (Laboratory) and/or Section 101 (Medical Imaging). These rates, as they are listed, apply to all provider types.

For questions about billing and claims, please contact Provider Services at 1-866-690-5585.