HCPCS			
86328	86318 plus pandemic modifier	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The allowance for these services was originally discussed and agreed upon among all CMS Medicare Administrative Contractors. MAC recommend no change be made to the current allowance for code 86328 during the Public Health Emergency."	Research of tests and comparison to existing similar tests. 
86769	86794 plus pandemic modifier	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The allowance for these services was assigned by the Centers for Medicare and Medicaid. We recommend no change be made to the current allowance for code 86769 during the Public Health Emergency."	Research of tests and comparison to existing similar tests. 
87635	87662/87501	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations  for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The allowance for these services was assigned by the Centers for Medicare and Medicaid. We recommend no change be made to the current allowance for code 87635 during the Public Health Emergency."	Research of tests and comparison to existing similar tests. 
U0001	Price similar to 87662/87501 less PCR provided by CDC 	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The allowance for these services was originally discussed and agreed upon among all Center for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs). MAC recommend no change be made to the current allowance for code U0001 during the Public Health Emergency."	Research of tests and comparison to existing similar tests. 
U0002	87662/87501	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The allowance for these services was originally discussed and agreed upon among all CMS Medicare Administrative Contractors. MAC recommend no change be made to the current allowance for code U0002 during the Public Health Emergency."	Research of tests and comparison to existing similar tests. 
U0003	Priced by CMS	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The allowance for these services was assigned by the Centers for Medicare and Medicaid. MAC recommend no change be made to the current allowance for code U0003 during the Public Health Emergency."	Research of tests and comparison to existing similar tests. 
U0004	Priced by CMS	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services. MAC reviewed the presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The allowance for these services was assigned by the Centers for Medicare and Medicaid. MAC recommend no change be made to the current allowance for code U0004 during the Public Health Emergency."	Research of tests and comparison to existing similar tests. 
0015M	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services.  MAC recommend crosswalk code 0002M for a recommended allowance of $553.74 for code 0015M. "	Research of tests and comparison to existing similar tests. 
0016M	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC recommend crosswalk code 81455 for a recommended allowance of $2,919.60 for code 0016M. "	"Using submitted information, comparison to other existing tests and research of other payer payments.  "
0101U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The allowance for these services was previously crosswalked by the CMS to code 81435 plus code 81436. Upon additional evaluation, MAC agreed that the work involved was similar to that of the original crosswalk plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $1,286.78 for code 0101U. "	Research of tests and comparison to existing similar tests. 
0102U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests.  The allowance for these services was previously crosswalked by the CMS to code 81432 plus code 81433. Upon additional evaluation, MAC agreed that the work involved was similar to that of the original crosswalk plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $1,229.78 for code 0102U. "	Research of tests and comparison to existing similar tests. 
0103U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests.  The allowance for these services was previously crosswalked by the CMS to code 81432 plus code 81433. Upon additional evaluation, MAC agreed that the work involved was similar to that of the original crosswalk plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $1,229.78 for code 0103U. "	Research of tests and comparison to existing similar tests. 
0129U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests.  The allowance for these services was previously crosswalked by the CMS to code 81432 plus code 81433. Upon additional evaluation, MAC agreed that the work involved was similar to that of the original crosswalk plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $1,229.78 for code 0129U. "	Research of tests and comparison to existing similar tests. 
0139U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services.  MAC agreed that the work involved was similar to that of code 0063U. MAC made an assumption that additional money for the algorithm is already included for code 0063U therefore, the recommended allowance is $750.00 for code 0139U."	"Using submitted information, comparison to other existing tests and research of other payer payments.  "
0140U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services. MAC reviewed the meeting presentations for this service for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests (CDLT). MAC evaluated the information and agreed with the information presented at the CDLT panel meeting. MAC agree the work involved was similar to code 87633 and recommend an allowance of $416.78 for code 0140U. "	Research of tests and comparison to existing similar tests. 
0141U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  Survey response received from stakeholders for these services. MAC reviewed the CDLT meeting presentations for this service. We evaluated the information and agreed with the information presented at the CDLT panel meeting. MAC agree the work involved was similar to code 87633 plus an additional $35.09 to account for the additional number of targets for a recommended allowance of $451.87 for code 0141U. "	Research of tests and comparison to existing similar tests. 
0142U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services. MAC reviewed the meeting presentations for this service for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests (CDLT). We agree the work involved was similar to code 87633 plus an additional $142.63 to account for the additional number of targets for a recommended allowance of $559.41 for code 0142U. "	Research of tests and comparison to existing similar tests. 
0143U	 Price similar to 0150U	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC reviewed the final determination for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests (CDLT). The final determination proposed code 0082U as a crosswalk which has the same rate as code 0150U. No cost information was received from the stakeholder therefore, MAC recommend code 0150U as a crosswalk noting the code descriptor is identical to the code descriptor for code 0143U as listed in the 2021 CPT manual. MAC recommend an allowance of $114.43 for code 0143U. "	Research of tests and comparison to existing similar tests. 
0144U	Price similar to 0150U	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC reviewed the final determination for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests (CDLT).  The final determination proposed code 0082U as a crosswalk which has the same rate as code 0150U. No cost information was received from the stakeholder. MAC recommend code 0150U as a crosswalk with a recommended allowance of $114.43 for code 0144U. "	Research of tests and comparison to existing similar tests. 
0151U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The American Society of Microbiology suggested the service be crosswalked to codes 87632 and 87633.  Upon evaluation, MAC used the assumption of fixed and variable costs extrapolated from codes 87632 and 87633 to get a cost of $14.19 per test. MAC used the crosswalk code 87633 plus ($14.19 x 8) for a recommended allowance of $530.33 for code 0151U. "	Research of tests and comparison to existing similar tests. 
0152U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services. MAC reviewed the meeting presentations for this service for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests (CDLT). MAC applied the 63/37% split to the submitted costs and used the reported test capacity to determine a recommended allowance of $988.30 for code 0152U. "	Research of tests and comparison to existing similar tests. 
0153U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services.  MAC used a crosswalk of code 81455 for a recommended rate of $2,919.60 for code 0153U."	Research of tests and comparison to existing similar tests. 
0156U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested a crosswalk code of 81229 times 1.5 for a total rate of $1740.00. MAC accepted the stakeholder rate of $1740.00 minus the stakeholder amount of $500.00 for the NGS algorithm. MAC added an allowance to account for the algorithm used to produce the results for a recommended allowance of $1,364.00 for code 0156U."	"Using submitted information, comparison to other existing tests and research of other payer payments.  "
0157U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested the service be crosswalked to 81201.  Upon evaluation, MAC determined that the work involved was similar to 30% of the primary procedure, code 81201, plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $257.40 for code 0157U. "	Research of tests and comparison to existing similar tests. 
0158U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested the service be crosswalked to 81292.  Upon evaluation, MAC determined that the work involved was similar to 30% of the primary procedure, code 81292, plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $222.88 for code 0158U. "	Research of tests and comparison to existing similar tests. 
0159U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested the service be crosswalked to code 81295.  Upon evaluation, MAC determined that the work involved was similar to 30% of the primary procedure, code 81295, plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $125.96 for code 0159U."	Research of tests and comparison to existing similar tests. 
0160U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested the service be crosswalked to code 81298.  Upon evaluation, MAC determined that the work involved was similar to 30% of the primary procedure, code 81298, plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $223.25 for code 0160U. "	Research of tests and comparison to existing similar tests. 
0161U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested the service be crosswalked to code 81317.  Upon evaluation, MAC determined that the work involved was similar to 30% of the primary procedure, code 81317, plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $223.25 for code 0161U. "	Research of tests and comparison to existing similar tests. 
0162U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested the service be crosswalked to code 81435.  Upon evaluation, MAC determined that the work involved was similar to 30% of the primary procedure, code 81435, plus an additional allowance to account for the algorithm used to produce the results for a recommended rate of $193.02 for code 0162U. "	Research of tests and comparison to existing similar tests. 
0163U	Price similar to 81500 /2= X3	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services.  MAC took 80% of the billed amount found in national comparison data of $350.00 plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $308.00 for code 0163U."	Research of tests and comparison to existing similar tests. 
0164U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services. MAC reviewed the final determination for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests (CDLT). The final determination proposed code 0082U as a crosswalk which was end-dated 12/31/2019. MAC used a crosswalk of code 0109U plus an additional allowance to account for the algorithm used to produce the results for a recommended rate of $156.89 for code 0164U."	Research of tests and comparison to existing similar tests. 
0165U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. The allowance for these services was originally discussed and agreed upon for the CMS Medicare Change Request 11681 from July 2020. We recommend no change be made to the current MAC allowance which is crosswalked to code 86008 time 5 for code 0165U. "	Research of tests and comparison to existing similar tests. 
0171U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the meeting presentation for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. MAC used a crosswalk of code 81450  for a recommended rate of $759.53 for code 0171U."	Research of tests and comparison to existing similar tests. 
0173U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services.  MAC used a crosswalk of code 81226 for a recommended rate of $450.91 for code 0173U."	"Using submitted information, comparison to other existing tests and research of other payer payments.  "
0174U	Price similar to  0015M	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services.  MAC used a crosswalk of code 81445 plus an additional allowance to account for the algorithm used to produce the results for a recommended rate of $657.70 for code 0174U."	Research of tests and comparison to existing similar tests. 
0175U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests.  MAC used a crosswalk of code 81226  for a recommended rate of $450.91 for code 0175U."	Research of tests and comparison to existing similar tests. 
0178U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services.  The allowance for these services was originally discussed and agreed upon for the CMS Medicare Change Request 11681 from July 2020. We recommend no change be made to the current MAC allowance which is crosswalked to code 86008 time 5 for code 0178U. "	Research of tests and comparison to existing similar tests. 
0179U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services.  MAC recommend crosswalk code 0022U which has a current allowance of $1,950.00 on the CMS Clinical Lab Fee Schedule for code 0179U. "	Research of tests and comparison to existing similar tests. 
0180U	price similar to 0188U	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. MAC suggest code 0198U as a crosswalk for a recommended rate of $282.88 for code 0180U."	Research of tests and comparison to existing similar tests. 
0206U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. MAC accepted the stakeholder list rate of $3000.00 for code 0206U minus the fixed royalty cost of $197.92; the variable royalty cost of $285.00 and the FedEx shipping cost of $182.87 for a final allowance of $2334.21 for code 0206U."	Research of tests and comparison to existing similar tests. 
0207U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. MAC accepted the stakeholder list rate of $3000.00 for code 0206U minus the fixed royalty cost of $197.92; the variable royalty cost of $285.00 and the FedEx shipping cost of $182.87 for a final allowance of $2334.21. For code 0207U, allowed 30% of the rate  for code 0206U which was $700.26 and subtracted the royalty cost of $127.08  for a final allowance of $573.18."	Research of tests and comparison to existing similar tests. 
0208U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. MAC accepted the stakeholder list rate of $981.65 for code 0208U. "	Research of tests and comparison to existing similar tests. 
0209U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services. MAC recommend crosswalk code 81425 with a rate of $5,031.20 for code 0209U. "	Research of tests and comparison to existing similar tests. 
0212U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested an allowance of $11,896.24. No cost data was submitted to substantiate that allowance. MAC agreed the work involved was similar to code 81455 and recommend an allowance of $2,919.60 for code 0212U.  "	"Using submitted information, comparison to other existing tests and research of other payer payments.  "
0213U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests.  The stakeholder requested an allowance of $9,574.99. No cost data was submitted to substantiate that allowance. MAC agreed the work involved was similar to code 81455 and recommend an allowance of $2,919.60 for code 0213U.  "	"Using submitted information, comparison to other existing tests and research of other payer payments.  "
0214U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested an allowance of $11,645.04. No cost data was submitted to substantiate that allowance. MAC agreed the work involved was similar to code 81455 and recommend an allowance of $2,919.60 for code 0214U.  "	"Using submitted information, comparison to other existing tests and research of other payer payments.  "
0215U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested an allowance of $18,865.04. No cost data was submitted to substantiate that allowance. MAC agreed the work involved was similar to code 81455 and recommend an allowance of $2,919.60 for code 0215U.  "	"Using submitted information, comparison to other existing tests and research of other payer payments.  "
0216U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. The stakeholder requested an allowance of $2,813.80. No cost data was submitted to substantiate that allowance. MAC agreed the work involved was similar to code 81445 and recommend an allowance of $597.91 for code 0216U.  "	"Using submitted information, comparison to other existing tests and research of other payer payments. "
0217U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC reviewed the presentations for this service from the June 22, 2020, meeting of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests.  The stakeholder requested an allowance of $3197.80. No cost data was submitted to substantiate that allowance. MAC agreed the work involved was similar to code 81455 and recommend an allowance of $2,919.60 for code 0217U.  "	"Using submitted information, comparison to other existing tests and research of other payer payments. "
0219U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services. The allowance for these services was originally discussed and agreed upon for the CMS Medicare Change Request 11937 from October 2020. MAC recommend crosswalk code 87901 plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $283.20 for code 0219U. "	Research of tests and comparison to existing similar tests. 
0220U	price determined following 42 CFR 414 subsection G	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. The stakeholder presented cost information for these services. MAC accepted the stakeholder list rate of $850.00 and removed the reported algorithm allowance of $313.00 for this service. MAC recommend the base rate of $537.00 plus an additional allowance to account for the algorithm for a recommended allowance of $590.70 for code 0220U. "	"Using submitted information, comparison to other existing tests and research of other payer payments. "
0221U	price similar to 0188U	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab. MAC received no survey response from stakeholders for these services.  The allowance for these services was originally discussed and agreed upon for the CMS Medicare Change Request 11937 from October 2020. MAC recommend crosswalk code 87901 plus an additional allowance to account for the algorithm used to produce the results for a final allowance of $283.20 for code 0221U. "	Research of tests and comparison to existing similar tests. 
0222U	price similar to 0198U	"On February 4, 2021, MAC requested cost information as outlined in The Protecting Access to Medicare Act (PAMA) and 42 CFR (Code of Federal regulations) Section(s) sections 414.507(g) and 414.508 from each proprietary lab.  MAC received no survey response from stakeholders for these services.  The allowance for these services was originally discussed and agreed upon for the CMS Medicare Change Request 11937 from October 2020. MAC recommend crosswalk code 87901 plus an additional allowance to account for the algorithm used to produce the results for a recommended allowance of $283.20 for code 0222U. "	Research of tests and comparison to existing similar tests. 
