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- Billing for the Professional Component of Clinical Pathology Services: CAP Resources
The CAP has guidance and information for its members on billing for the professional component of clinical pathology services. In professional component billing, although the hospital may bill the patient’s insurer for the pathologist’s technical services, the pathologist can bill the insurer or the hospital directly for the corresponding professional services. The CAP supports professional component billing as one valid method of billing by pathologists for their clinical pathology services.
For several years, the CAP has provided its members with support and an information package providing additional explanation of this issue with copies of guidance documents from the American Medical Association, an overview of the positions of private insurance companies, and a summary of key private litigation on professional component billing for non-Medicare patients. A CAP-member login is required to download the information package.
For more resources, go to the CAP’s practice management webpage for Contracts-Negotiations and Fee Schedules.