1. Home
  2. Advocacy
  3. Lobbying and Political Action
  4. State Advocacy and Billing For Pathology Services

State Advocacy and Billing For Pathology Services


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.


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.

Read the direct billing issue brief

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.