Reminder: CLIA Certification Required for Laboratory Service Claims
AI Summary
All laboratory service providers must maintain current CLIA certification and submit certification information through the Provider Enrollment and Management System (PEMS). Providers can only bill for laboratory services that are covered under their current CLIA certification, with specific processes for updating certification information during enrollment, revalidation, or maintenance periods.
Action Required
Immediately: Laboratory service providers must verify current CLIA certification is submitted in PEMS and ensure all laboratory claims match services covered under their certification. Billing team should review all laboratory service claims to confirm CLIA compliance before submission. Update CLIA information through appropriate PEMS transaction type based on enrollment status. Claims for services not covered under current CLIA certification will be denied.
Plan Types
All Plans
States
TX
Specialties
laboratory, all-specialties