---
kind: "section"
citation: "42 C.F.R. § 414.523"
title: "42"
number: "414.523"
heading: "Payment for laboratory specimen collection fee and travel allowance."
url: "https://uscodex.org/cfr/42/414.523"
---

# §414.523. Payment for laboratory specimen collection fee and travel allowance.

- (a) **Specimen collection fee and travel allowance.** In addition to the payment amounts provided under this subpart for CDLTs, new CDLTs, and new ADLTs, CMS pays a specimen collection fee, as set forth in [paragraph (a)(1)](#a-1) of this section, and a travel allowance, as set forth in [paragraph (a)(2)](#a-2) of this section.
  - (1) **Payment for specimen collection.** Except as provided in [paragraph (a)(1)(v)](#a-1-v) of this section and subject to the annual update in [paragraph (a)(1)(iv)](#a-1-iv) of this section, beginning January 1, 2023, CMS pays $8.57 for all specimens collected in one patient encounter, where the specimen(s) is:
    - (i) Used to perform a CDLT paid under this subpart G;
    - (ii) **Collected by a trained technician from a Medicare beneficiary who is—**
      - (A) Homebound as described in [42 CFR 424.22(a)(1)(ii)](/cfr/42/424.22.md?p=a-1-ii).
      - (B) A non-hospital inpatient, but only when no qualified personnel are available at the facility to collect the specimen;
    - (iii) **Of the following type—**
      - (A) **Blood specimen collected through venipuncture.**
      - (B) **A urine sample collected by catheterization.**
    - (iv) Beginning January 1, 2024, CMS updates the specimen collection fee amount under [paragraph (a)(1)](#a-1) of this section for each calendar year by the percent change in the Consumer Price Index for All Urban Consumers (CPI-U) (U.S. city average) for the 12-month period ending June 30th of the year preceding the update year.
    - (v) **For a specimen collected from a Medicare beneficiary.**
  - (2) **Payment for travel allowance—**
    - (i) **General requirement.** CMS pays a travel allowance, as calculated under [paragraph (a)(2)(iii)](#a-2-iii) of this section, where the specimen is one for which a specimen collection fee is paid under [paragraph (a)(1)](#a-1) of this section.
    - (ii) **Travel allowance basis.** CMS pays a travel allowance on the following bases:
      - (A) **Flat-rate travel allowance.** The flat-rate travel allowance applies when the trained technician travels 20 eligible miles or less (calculated in accordance with [paragraph (a)(2)(iii)(A)](#a-2-iii-A) of this section) to and from one location for specimen collection from one or more Medicare beneficiaries; or
      - (B) **Per-mile travel allowance.** The per-mile travel allowance applies when:

        (1) The trained technician travels more than 20 eligible miles (calculated in accordance with [paragraph (a)(2)(iii)(A)](#a-2-iii-A) of this section) to and from one location for specimen collection from one or more Medicare beneficiaries; or

        (2) The trained technician travels to more than one location for specimen collection from more than one Medicare beneficiary.

    - (iii) **Travel allowance amount—**
      - (A) **Eligible miles.** Eligible miles begin at the laboratory or the starting point of the technician's travel for specimen collection as specified in [paragraph (a)(1)](#a-1) of this section, and end at the laboratory or the ending point of the technician's travel for specimen collection as specified in [paragraph (a)(1)](#a-1) of this section. Eligible miles do not include miles traveled for any purpose unrelated to specimen collection as specified in [paragraph (a)(1)](#a-1) of this section, such as collecting specimens from non-Medicare beneficiaries or for personal reasons.
      - (B) **Travel allowance mileage rate.** The travel allowance mileage rate is equal to the IRS standard mileage rate plus an amount to cover expenses for a trained technician equal to the most recent median hourly wage for phlebotomists, as published by the United States Bureau of Labor Statistics, divided by 40 to represent an average miles-per-hour driving speed.
      - (C) **Travel allowance amount calculation.** (1) For the flat-rate travel allowance basis specified in [paragraph (a)(2)(ii)(A)](#a-2-ii-A) of this section, the travel allowance amount is the travel allowance mileage rate specified in [paragraph (a)(2)(iii)(B)](#a-2-iii-B) of this section multiplied by ten, divided by the number of beneficiaries for whom a specimen collection fee is paid under [paragraph (a)(1)](#a-1) of this section.

        (2) For the per-mile travel allowance basis specified in [paragraph (a)(2)(ii)(B)](#a-2-ii-B) of this section, the travel allowance amount is the number of eligible miles multiplied by the travel allowance mileage rate specified in [paragraph (a)(2)(iii)(B)](#a-2-iii-B) of this section, divided by the number of beneficiaries for whom a specimen collection fee is paid under [paragraph (a)(1)](#a-1) of this section.

- (b) [Reserved]

## Notes

### Amendments

[87 FR 70225, Nov. 18, 2022]

### Source

Source: 71 FR 69786, Dec. 1, 2006, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302, 1395hh, and 1395rr(b)(l).

### Source

Source: 55 FR 23441, June 8, 1990, unless otherwise noted.

### Amendments

[87 FR 70225, Nov. 18, 2022]