PAMA Lab Test Private Payor Rate Reporting

Time: 11:00 AM


11 am to Noon



Registration is complimentary for IHA members.

Register Online

Is your outreach laboratory submitting claims for non-patient services under the Protecting Access to Medicare Act of 2014 (PAMA)? These claims must comply with a new reporting requirement from the Centers for Medicare & Medicaid Services (CMS). Hospitals that received at least $12,500 in Medicare revenues for clinical laboratory fee schedule (CLFS) claims billed on the 14x Type of Bill between Jan. 1, 2019 and June 30, 2019 are required to report the corresponding private payor rates.

This expert-led session will help you understand and ensure compliance with complex CMS requirements. Specifically, you’ll learn how to decipher the regulatory requirement to report private payor rates for Medicare-covered tests via the CLFS.


At the end of this presentation, participants will be able to:

  • Describe a better understanding of the CMS mandate for lab reporting under PAMA;

  • Recognize if your hospital is considered an “applicable laboratory” for reporting; and

  • Identify the consequences for not reporting private payor rates.

Who Should Attend

This webinar has been designed for the following hospital and health system leaders:

  • CEOs;

  • CFOs and other finance staff; and

  • Chief Compliance Officers.


Monica Lelevich, Director, Audit Services, PARA Healthcare Financial Services
Prior to joining PARA in 2012, Lelevich spent nine years as director of contracts and director of patient financial services at PeaceHealth, an integrated delivery system in Washington State. She was also business office director for Kaiser Permanente Northwest in Portland, Oregon, and revenue cycle director for St. John’s Medical Center in Jackson, Wyoming. Lelevich’s experience in cost analysis and contracts management extends to other industries, though she specializes in physician and hospital revenue cycle operations. At PARA, she is responsible for conducting Revenue Integrity Program meetings and providing on-site client audit services.