Updates to New York State Medicaid professional pathology policy

As outlined in the New York State Medicaid professional pathology policy, New York State (NYS) Medicaid fee-for-service (FFS) has started to reimburse participating laboratories and facilities for any consultation on pathology specimens, effective April 1, 2022. For Medicaid Managed Care (MMC) plans, including Mainstream MMC Plans, Human Immunodeficiency Virus (HIV) Special Needs Plans (HIV-SNPs), and Health and Recovery Plans (HARPs), the policy will be effective on June 1, 2022. Reimbursement is available for consultations after the initial specimen reading, but the following criteria must be met: