State Advocacy and Billing
for Pathology Services

 

Background

The College of American Pathologists (CAP) supports direct billing for anatomic and clinical pathology services for all payers, public, and private.

The CAP believes payment for anatomic and clinical pathology services should be made only to the person or entity who performed or supervised the service, except for referrals between laboratories independent of a physician's office. This policy, known as "direct billing," is consistent with American Medical Association ethics principles and has been a Medicare requirement since 1984.

The CAP Resources

Issue Brief

This issue brief is a high-level synopsis of the issue and our public policy position used to educate and influence policymakers and key stakeholders.

Direct Billing (PDF, 110 KB)

State Billing Laws

This information allows members to bill for their services in compliance with state law. The most frequent member inquiry to State Affairs entails this information.

  • Direct Billing
    Arizona, California, Colorado, Connecticut, Massachusetts, Nevada, New Jersey, New York, Rhode Island, Louisiana, Ohio, South Carolina, Tennessee, Indiana, Iowa, Maryland, Montana, Kansas, and Washington
  • Anti-Markup
    California, Florida, Illinois, Michigan, Oregon, Pennsylvania, Utah, Virginia, and Washington
  • Disclosure
    Arizona, Connecticut, Delaware, Florida, Louisiana, Maine, Maryland, Nebraska, North Carolina, Ohio, Pennsylvania, Texas, Vermont, New Jersey, Tennessee, and Utah

State Legal Opinions

These state legal opinions inform members as the specifics of their legal compliance with state law as it relates to billing for their services.