This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Joseph H. Keffer, MD
American Society of Clinical Pathologists Chicago, Ill

JAMA. 1990;263(4):514.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

While I agree with Dr Ohrt¹ that Medicare, with its requirement of direct billing, has taken an important step toward improving the economic incentive to provide quality testing, the current Medicare fee schedule does not provide clinical laboratories with adequate payment for these important services.

Papanicolaou smears are reimbursed on the basis of carrier-wide fee schedules under Medicare, ranging from a lowof $4.11 in Missouri to a national cap of $9.10 in California and Alaska. Even if these payments covered current costs of performing the test, which they do not, the cost of providing this service must increase. This will cause serious access problems in the future. The shortage of cytotechnologists and the resulting salary wars have already affected costs and turnaround time. Pending legislation, which provides Medicare coverage of Papanicolaou smear testing for the first time as a screening test, will further overwhelm the system. . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?