Medicare Lab Reimbursement: Labs Will Soon Be Required to Provide COVID-19 Test Results Within Two Days For Full Payment

From January 1, 2021, the Centers for Medicare & Medicaid Services will penalize U.S. laboratories failing to process coronavirus diagnostic tests within two calendar days of collection by decreasing their reimbursement payments to $75 per test. However, labs that consistently comply with this guideline will be rewarded by Medicare with a $25 add-on payment. 

These changes create major incentives for laboratories to consistently process samples quickly which usually requires a robust laboratory information system (LIS meaning medical). LigoLab’s integrated LIS Laboratory Information System (LIS software) provides a robust and secure platform to support labs in their operations. 

The TestDirectly Direct-to-Consumer Lab Testing Portal is a web-based, scalable, agnostic add-on to LigoLab’s LIS system or any other LIS system. TestDirectly (and TestDirectly.com) can be deployed in a matter of days, and, once optimized, can improve average turnaround times to under 30 hours from sample collection through a variety of means, including having patients self-register online; replacing paper requisitions and manual labor with a streamlined electronic workflow; enabling tracking of all specimens; and automated reporting of results to patients and their followup.

Soon, U.S. laboratories that fail to process coronavirus diagnostic tests within two calendar days of collection will be penalized with smaller Medicare reimbursement payments from the Centers for Medicare & Medicaid Services. 

CMS on Thursday announced that starting on January 1, 2021, the base payment rate for COVID-19 diagnostic tests will drop to $75 per test, and Medicare will make an additional $25 add-on payment to laboratories if they complete the tests in two calendar days or less, and if they complete the majority of their COVID-19 tests in two calendar days or less for all patients (not just their Medicare patients) in the previous month. 

“Today’s announcement supports faster high throughput testing, which will allow patients and physicians to act quickly and decisively concerning treatment decisions, physical isolation, and contact tracing,” said CMS Administrator Seema Verma.

Click Here for Thursday’s announcement. 

For laboratories already struggling to meet this two-day turnaround time, the CMS announcement serves as a wake-up call and will likely lead to the reexamination of clinical lab workflow and LIS software solutions.

Fortunately for them, the TestDirectly Direct-to-Consumer Lab Testing Portal is a streamlined laboratory information system solution that drives faster turnaround times and with it, these struggling labs will have the tool needed to ensure the full Medicare lab reimbursement of $100 per case going forward. 

The TestDirectly Portal is the latest addition to the fully integrated LigoLab LIS & RCM Informatics Platform. It’s a web-based and scalable laboratory customer service software that interfaces with any laboratory information system (molecular LIS) and any instrumentation for COVID-19 testing. 

With TestDirectly (and TestDirectly.com), the average turnaround time for labs using the platform is 30 hours from collection. Even better, portal implementation typically takes just one-to-two weeks, giving labs in need of more efficient operations plenty of time to upgrade their LIS system functionality before the CMS payments are adjusted.

Once in place, the portal works seamlessly with the LIS system to replace paper requisitions and manual labor with a streamlined electronic lab workflow that starts with patient self-registration. This benefits both collection organizations and laboratories because it removes the manual order entry and follow-up bottlenecks, enables the tracking of all specimens with barcodes, boosts testing capacity, and improves turnaround times. 

Accessioning starts when the patient creates an account with an email address at TestDirectly.com. From there, he or she can find a nearby collection site, schedule an appointment, input all demographics (including laboratory billing details that can be verified and/or charged in real-time), answer the required order entry questions, agree to terms, and place the order. 

By deploying TestDirectly, laboratories can easily connect with patients, physicians, employers, school and university systems, industries, and governmental agencies to deliver the fast and accurate TestDirectly results time that patients need for peace of mind while also helping their bottom line.

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More TestDirectly Resources 

How TestDirectly Helped DuPage County Create a More Efficient Drive-Through With Faster Test Results

TestDirectly Eliminates the Paper Requisitions That Cause Accessioning Headaches

How Our Lab Partner Embraced Innovation and Won a Statewide Testing Contract

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Why Choose LigoLab?

In addition to the TestDirectly Direct-to-Consumer Lab Testing Portal, LigoLab’s all-in-one platform also includes customizable modules for Anatomic Pathology, Clinical Pathology, Molecular Diagnostics, and Lab Billing (Lab RCM), plus supporting modules and supporting engines that connect, merge, and integrate all laboratory operations and financial processes within one common database and operating system. This means no more silos, no more middleware, and no more inconsistent data.