HCPCS G0471 Sample Collection Fee Adjustment for Clinical Laboratory Fee Schedule and Laboratory Services

When a sample is collected by a laboratory from an individual in a SNF or from an individual on behalf of a HHA, the Healthcare Common Procedure Coding System (HCPCS) code, G0471 “Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a SNF or by a laboratory on behalf of a HHA,” is used. Effective April 1, 2014, the nominal fee is increased by $2, from $3 to $5, in accordance with the Protecting Access to Medicare Act (PAMA). 

The “Sample Collection Fee” is raised from $3.00 to $5.00 ONLY when the following statements apply: 

• The sample is being collected by a laboratory technician that is employed by the laboratory that is performing the test, and

• The sample is from an individual in either a SNF or a HHA.

MACs will not search their files to adjust claims already processed. However, they will adjust such claims that you bring to their attention.

Reference: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8837.pdf

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