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Independent Laboratory Services

Independent Laboratory providers are identified by an eight-digit provider number beginning with 37. For information regarding laboratory services for all other providers, please call the Medicaid representative for the provider program, such as hospital, ambulatory surgical clinics, renal dialysis, etc.

Kentucky Medicaid laboratory provider eligibility criteria include:

  • CLIA certified to perform laboratory services; and
  • See 907 KAR 1:028 for new laboratory director requirements.

A laboratory provider may perform Medicaid laboratory services for Medicaid recipients only to the extent authorized by the provider's CLIA certificate. Laboratory services do not require prior authorization, but must be medically necessary.

Reimbursement for independent lab is based on the Kentucky Medicare fee schedule. For previous versions of the Fee Schedule, refer to the Archive Fee Schedule listed below).

Program Updates

2010 Updates

Effective April 15, 2010 codes 80100 and 80101 will be replaced with G0430 and G0431. Please use the appropriate codes for dates of service beginning April 15. If you have questions, please call (502) 564-2687.

Clinical Laboratory Archive Fee Schedules

 

Regulations, Policy Information, Provider Letters and Billing Information
 

Regulations

  • 907 KAR 1:028
  • 907 KAR 1:575 - Compliance with Laboratory and X-ray Services

Policy Information
Policy information is contained in 907 KAR 1:028.

Provider Letters

To view other provider letters, refer to the Provider Letter page.

Billing Information
Provider Billing Instructions

Fee Schedule
To view the most current Fee Schedule, refer to the Fee and Rate Schedule page.

 

Contact Information:
 

Regarding policy, contact
Division of Policy and Operations
Benefit Policy Branch
275 E. Main St., 6W-D
Frankfort, KY 40621
Phone: (502) 564-6890
Email:  CHFS DMS Webmaster

Regarding billing, contact EDS at (800) 807-1232 or visit their website

Regarding members, contact Member Services (800) 635-2570

Regarding Provider Enrollment, contact Provider Enrollment at (877) 838-5085 or visit their website.

 

Last Updated 3/3/2015