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).
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.
||Archive Fee Schedules
Clinical Laboratory Fee Schedule as of Jan 2011: PDF - Excel
Clinical Laboratory Fee Schedule as of Jan. 2010: PDF - Excel
Clinical Laboratory Fee Schedule as of Feb. 2009: PDF - Excel
Clinical Laboratory Fee Schedule as of April 2008: PDF
Clinical Laboratory Fee Schedule as of March 2007: PDF