Billing
Referring and reference laboratories
View this outline of key definitions, billing responsibilities, and claim submission requirements for referred laboratory services to ensure correct reporting, avoid duplicate billing, and maintain…
Referring and reference laboratories
View this outline of key definitions, billing responsibilities, and claim submission requirements for referred laboratory services to ensure correct reporting, avoid duplicate billing, and maintain…
2025 influenza, pneumococcal, and hepatitis B vaccine reimbursement
Read this article for information on vaccine fees for calendar year 2025.
Laboratory date of service
Clarification regarding clinical laboratory date of service (DOS) billing. The DOS for clinical laboratory tests and the technical component of physician pathology services is governed by 42 CFR 414.…
MSP billing
Read this article for more information on billing your claims when Medicare is the secondary payer.
End stage renal disease (ESRD) billing reminders and quarterly updates
Review this article to view common billing errors and how to review quarterly ESRD updates.
Allowing electronic submission of medically denied cancel claims
To determine if a claim was medically reviewed, providers should submit the requests correctly.
Hospital off-campus outpatient department reporting requirements
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code 34554 if modifier ER, PO, or PN is billed on all service lines, and…