CMS Fee Schedule Reimbursement for the Second Generation FIT test by state

The 2015 Clinical Laboratory Fee Schedule for 2016 will be released shortly, and is expected to remain consistant with the 2015 Fee Schedule for reimbursement of the Second Generation FIT Colon Cancer Screening Test.  

Since 2012, Guaiac based (Hemmocult or similar) card tests have been grouped into the "global" CMS fee, therefore not reimbursable.  The Second Generation FIT test remains a profit-responsive tests that directs the right people to colonoscopy in population-based screening.  Below is allowable reimbursement, by state, for the Second Generation FIT test.

 

G0328 Fecal Blood Screen Immunoassay

Amount

ALABAMA-Entire State

$21.65

ALASKA-Entire State

$21.65

ARIZONA-Entire State

$18.02

ARKANSAS-Entire State

$21.65

CALIFORNIA NORTH-Marin/Napa/Solano -

$21.65

CALIFORNIA NORTH-San Francisco

$21.65

CALIFORNIA NORTH-San Mateo

$21.65

CALIFORNIA NORTH-Oakland/Berkeley

$21.65

CALIFORNIA NORTH-Santa Clara

$21.65

CALIFORNIA NORTH-Rest of North California

$21.65

CALIFORNIA SOUTH-Ventura

$21.65

CALIFORNIA SOUTH-Los Angeles

$21.65

CALIFORNIA SOUTH-Anaheim/Santa Ana

$21.65

CALIFORNIA SOUTH-Rest of South California

$21.65

COLORADO-Entire State

$21.65

CONNECTICUT-Entire State

$19.75

DELAWARE-Entire State

$21.65

DIST of COL-DC + MD/VA Suburbs

$21.65

FLORIDA-Ft Lauderdale

$21.65

FLORIDA-Miami

$21.65

FLORIDA-Rest of Florida

$21.65

GEORGIA-Atlanta

$21.65

GEORGIA-Rest of Georgia

$21.65

HAWAII/ GUAM - Entire state/ terrritory

$21.65

IDAHO-Entire State

$21.65

ILLINOIS-East St. Louis

$21.65

ILLINOIS-Suburban Chicago

$21.65

ILLINOIS-Chicago

$21.65

ILLINOIS-Rest of Illinois

$21.65

INDIANA-Entire State

$21.65

IOWA-Entire State

$21.65

KANSAS-Entire State

$21.65

KENTUCKY-Entire State

$21.65

LOUISIANA-New Orleans

$21.65

LOUISIANA-Rest of Louisiana

$21.65

MAINE-Southern Maine

$18.98

MAINE-Rest of Maine

$18.98

MARYLAND-Baltimore and suburbs

$21.65

MARYLAND-Rest of Maryland

$21.65

MASSACHUSETTS-Boston

$20.17

MASSACHUSETTS-Rest of Massachusetts

$20.17

MICHIGAN-Detroit

$21.65

MICHIGAN-Rest of Michigan

$21.65

MINNESOTA-Entire State

$21.65

MISSISSIPPI-Entire State

$12.26

MISSOURI-Kansas City

$21.65

MISSOURI-St. Louis

$21.65

MISSOURI-Rest of Missouri

$21.65

MONTANA-Entire State

$21.65

NEBRASKA-Entire State

$21.65

NEVADA-Entire State

$21.65

NEW HAMPSHIRE-Entire State

$18.99

NEW JERSEY-Northern NJ

$21.65

NEW JERSEY-Rest of New Jersey

$21.65

NEW MEXICO-Entire State

$21.65

NEW YORK-Manhattan

$21.65

NEW YORK-NYC Suburbs/LI

$21.65

NEW YORK-Poughkpsie/No NYC Sub

$21.65

NEW YORK-Rest of New York

$16.95

NEW YORK-Queens

$21.65

NORTH CAROLINA-Entire State

$21.65

NORTH DAKOTA-Entire State

$21.65

OHIO-Entire State

$21.65

OKLAHOMA-Entire State

$21.65

OREGON-Portland

$21.65

OREGON-Rest of Oregon

$21.65

PENNSYLVANIA-Philadelphia

$21.65

PENNSYLVANIA-Rest of Pennsylvania

$21.65

PUERTO RICO-Entire Territory

$21.65

RHODE ISLAND-Entire State

$21.40

SOUTH CAROLINA-Entire State

$12.28

SOUTH DAKOTA-Entire State

$21.65

TENNESSEE-Entire State

$21.65

TEXAS-Brazoria

$21.65

TEXAS-Dallas

$21.65

TEXAS-Galveston

$21.65

TEXAS-Houston

$21.65

TEXAS-Beaumont

$21.65

TEXAS-Fort Worth

$21.65

TEXAS-Austin

$21.65

TEXAS-Rest of Texas

$21.65

UTAH-Entire State

$16.45

VERMONT-Entire State

$16.45

VIRGINIA-Entire State

$21.65

WASHINGTON-Seattle (King County)

$21.65

WASHINGTON-Rest of Washington

$21.65

WEST VIRGINIA-Entire State

$21.65

WISCONSIN-Entire State

$21.65

WYOMING-Entire State

$21.65