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Securing Your Assay's CPT Code: A Guide to US Reimbursement and the CLFS
This episode details the process of obtaining a unique CPT or PLA code for a diagnostic assay in the U.S. and its direct impact on reimbursement under the Medicare Clinical Laboratory Fee Schedule (CLFS). We cover the application steps with the American Medical Association (AMA), the role of the PAMA Act, and recent legislative updates affecting payment rates and reporting deadlines. • What is a Proprietary Laboratory Analyses (PLA) code and why is it crucial for my new assay? • What is the step-by-step process for submitting a PLA code application to the AMA? • Who are the CPT Editorial…
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