The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). The objective of the CLIA program is to help ensure quality laboratory testing.


A valid CLIA certificate identification number is required and must be included on each electronic claim billed for laboratory services, subject to CLIA legislation. You may not receive reimbursement for your electronic claims if the required certification number is missing.


Apply for a CLIA Certificate here. This CMS mandate went in to effect on May 1, 2020. Please work with your software vendor or clearinghouse to ensure that the required information is included in your electronic files to avoid EDI claim rejections.


For detailed information on the tests subject to CLIA, please refer to this CMS link.                      



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August 2020 Anthem Maine Provider News