US · guidance
CMS Pub. 100-04, ch. 16, § 110.1
Coordination Between A/B MACs (B) and A/B MACs (A)/RRB
The A/B MAC (B) furnishes copies of fees that are locally established under the fee
schedules (price code = 22) to A/B MACs (A) and to the RRB Specialty MAC (S MAC).
The A/B MAC (B) must provide updates at least 30 days prior to the A/B MAC (B)’s
scheduled implementation of the update. The A/B MACs (A) add these fees to system
fee schedule tables to use in paying for hospital laboratory tests performed for both
outpatients of the hospital and persons who are not patients of the hospital. The RRB S
MAC uses the fee schedules in paying for outpatient clinical laboratory tests.
A/B MACs (A) and the RRB may consult with A/B MACs (B) on filling gaps in fee
schedules for tests where the A/B MAC (B) may not have established an amount. If an
A/B MAC (A) or the RRB S MAC has bills for payment on laboratory tests for which the
A/B MAC (B) has not furnished amounts, it consults with the A/B MAC (B). If
necessary the A/B MAC (B) consults with other nearby A/B MACs (B).
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
01ab58ac0fe2156b76657efe72cb8edfb1810ad26c6466737830cbd4dc9cf6cb
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