CMS revises Travel Allowance Rate
The Centers for Medicare & Medicaid Services has revised the 2017 travel allowance flat rate for laboratory technicians in accordance with the Internal Revenue Service.
Medicare Part B will pay a travel allowance for a laboratory technician to draw a specimen from either a nursing home patient or homebound patient, provided the specimen collection fee is also payable. Payment for these services is made based on the Clinical Laboratory Fee Schedule.
Travel codes allow for payment either on a per – mileage basis (P9603) or on a flat rate per trip basis (P9604), depending on the Medicare administrative contractor?s (MAC) preference.
- P9603Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home or nursing home bound patient; prorated miles actually traveled ? The allowance remains $0.535 per mile, plus an additional $0.45 per mile to cover the technician?s time and travel costs. MACs have the option of establishing a higher per mile rate if local conditions warrant it.
- P9604Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home or nursing home bound patient; prorated trip charge ? The updated flat rate per trip basis travel allowance is $9.85.
The per mile travel allowance is appropriate for use where the average trip to the patients? homes is longer than 20 miles, round trip. Payment is prorated based on the number of specimens collected per trip, and on the number of specimens drawn from non-Medicare patients in the same trip.
According to CMS, audits have shown the abuse of the per mile method, so many MACs have established local policy to pay based on a flat rate per trip basis only.
These payment rates are effective Jan. 1, 2017. MACs have until May 12, 2017, to implement these rates.