Frequency of Laboratory Tests

Medicare covers laboratory tests only when ordered by a physician who promptly receives and uses the test result to manage the beneficiary's specific medical problem; standing orders do not qualify for separate payment. Frequency limits apply to lipid, thyroid, glucose, and glycated hemoglobin/protein testing per the Utilization Guidelines, glucose monitoring devices are covered under Part B DME only when used in the home, and routine glucose monitoring in SNFs is never covered.

"A laboratory service is reasonable and necessary only when ordered by a physician who uses the test result in the management of the beneficiary's specific medical problem."

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