In the proposed 2023 Medicare Physician Fee Schedule released July 7, the CMS announced changes to the histotechnologist’s clinical labor rate that is used in the valuation of the technical components and global payment of all of pathology’s most frequently billed services. Increases in all clinical labor rates will be phased in over the next three years and the histotechnologist’s labor increase represents a rate greater than 16% than what the CMS previously finalized. Since final 2022 regulation until the proposed 2023 regulation, the CAP worked to achieve the increase that will have a positive effect on how much pathologists are paid for the technical component of pathology services.

When the CMS published its Final 2022 Medicare Physician Fee Schedule, the CAP immediately identified a rank order anomaly between the clinical labor rates of laboratory technicians and histotechnologists. The CAP then setup a meeting with the CMS to persuading the agency to correct the mistake.

The CAP conducted its due diligence to provide evidence to fix the error. The CAP reviewed a variety of data points that convinced CMS officials to change the rates. This information included:

• Per minute rate rank orders of all the CMS clinical labor types based on the Bureau of Labor Statistics.
• Historical precedence for wage differentials between laboratory technologists and laboratory technicians.
• Current open histotechnologist job offerings
• And, published wage data from the American Society for Clinical Pathology.

The CAP’s recommendations to fix the issue were published in the 2023 proposed physician fee schedule. Specifically, the CAP recommended within CMS’s practice expense methodology for the histotechnologist’s clinical labor rate per minute to increase from $0.37 to $0.64 (+73%) and laboratory technician/histotechnologist labor rate be increased by 71% to a rate of $0.60, rather than to $0.55 as finalized last year. The changes to these clinical labor rates will restore the proper rank order of the rates from what the CMS had altered in its final 2022 ruling. The CMS agreed with the CAP’s recommendations and has proposed the corrected rates as requested by the CAP in the 2023 Medicare fee schedule.