Medicare Specimen Collection Travel Allowance Increases

March 2017 ~

Effective Date: January 1, 2017

Implementation Date: May 12, 2017

For physicians, providers and suppliers submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries, the Medicare Part B specimen collection travel allowance will increase from $0.99 to $1.03 per mile and from $9.90 to $10.30 for a flat-rate trip.

Retroactive to January 1, this change revises the payment of travel allowances when billed on a per mileage basis using Health Care Common Procedure Coding System (HCPCS) code P9603 and when billed on a flat-rate basis using HCPCS code P9604 for Calendar Year (CY) 2017.

Payment of the travel allowance is made only if a specimen collection fee is also payable and MACs will have the option to choose either a mileage basis or a flat rate.

Under either method, when one trip is made for multiple specimen collections (for example, at a nursing home), the travel payment component is prorated based on the number of specimens collected on that trip. This applies to both Medicare and non-Medicare patients, either at the time the claim is submitted by the laboratory or when the flat rate is set by the MAC.

The standard mileage rate for businesses is determined by the Internal Revenue Service (IRS) based on periodic studies of the fixed and variable costs of operating an automobile.

For more information, refer to MLN Matters® Number: MM9960


Source(s): CMS; Klipp, J. D. (2017, March). Medicare Specimen Collection Travel Fee Increased. Laboratory Economics, Volume 12 (No. 3), pp. 10.