Cost analysis for CPT P9603 — Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled
Average Medicare Payment
$1.06
2023 data
Total Payments (2023)
$48.4M
Services (2023)
46.3M
Price Change (2014–2023)
+19.1%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $0.89 | $61.5M | 81.5M | — |
| 2015 | $0.96 | $61.9M | 70.9M | +7.9% |
| 2016 | $0.98 | $57.8M | 63.7M | +2.1% |
| 2017 | $0.95 | $60.1M | 65.1M | -3.1% |
| 2018 | $0.95 | $59.8M | 63.3M | 0.0% |
| 2019 | $0.96 | $58.1M | 60.1M | +1.1% |
| 2020 | $0.98 | $57.5M | 57.8M | +2.1% |
| 2021 | $1.01 | $41.3M | 41.9M | +3.1% |
| 2022 | $1.02 | $40.8M | 41.0M | +1.0% |
| 2023 | $1.06 | $48.4M | 46.3M | +3.9% |
The most expensive state pays 6.0x more than the cheapest for this procedure. CA averages $1.10 vs PA at $0.18.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| CA | $1.10 | $4.1M | 3.7M | 17 |
| DE | $1.09 | $376.8K | 345.2K | 3 |
| WA | $1.09 | $73.1K | 67.1K | 5 |
| MN | $1.09 | $1.8K | 1.7K | 3 |
| IN | $1.09 | $55.0K | 50.6K | 2 |
| OR | $1.09 | $26.5K | 24.4K | 1 |
| SC | $1.09 | $59.2K | 54.4K | 2 |
| UT | $1.09 | $67.2K | 61.8K | 2 |
| MS | $1.09 | $119.0K | 109.4K | 4 |
| GA | $1.09 | $1.5M | 1.4M | 4 |
| CO | $1.09 | $360.6K | 331.8K | 5 |
| ND | $1.09 | $173.2K | 159.4K | 1 |
| NJ | $1.09 | $2.5M | 2.3M | 10 |
| NV | $1.09 | $1.4M | 1.3M | 4 |
| MD | $1.09 | $257.9K | 237.5K | 3 |
| MA | $1.08 | $1.2M | 1.1M | 4 |
| IL | $1.08 | $9.5M | 8.8M | 41 |
| MI | $1.08 | $52.8K | 48.8K | 6 |
| OK | $1.08 | $377.6K | 349.0K | 3 |
| MO | $1.08 | $1.1M | 1.0M | 9 |
| ME | $1.08 | $12.6K | 11.6K | 1 |
| TX | $1.07 | $2.3M | 2.1M | 31 |
| AL | $1.07 | $650.0K | 608.4K | 6 |
| AZ | $1.07 | $1.3M | 1.2M | 6 |
| NY | $1.07 | $52.8K | 49.5K | 2 |
| FL | $1.07 | $10.7M | 10.1M | 37 |
| TN | $1.07 | $164.3K | 154.3K | 4 |
| AR | $1.06 | $265.5K | 249.5K | 3 |
| VA | $1.06 | $2.0M | 1.9M | 5 |
| NC | $1.06 | $1.4M | 1.3M | 6 |
| KS | $1.06 | $239.4K | 225.9K | 6 |
| OH | $1.05 | $3.7M | 3.5M | 8 |
| LA | $1.05 | $1.3M | 1.2M | 4 |
| WI | $1.04 | $112.2K | 107.7K | 5 |
| RI | $0.97 | $79.3K | 82.2K | 1 |
| KY | $0.96 | $755.4K | 787.3K | 3 |
| PA | $0.18 | $246.2K | 1.3M | 8 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| American Health Mw, Llc | Clinical Laboratory | OH | $3.6M | 3.4M | $1.05 |
| American Health S, Llc | Clinical Laboratory | FL | $2.8M | 2.6M | $1.08 |
| Star Lab, Inc | Clinical Laboratory | IL | $2.5M | 2.3M | $1.09 |
| Vista Clinical Diagnostics Llc | Clinical Laboratory | VA | $2.0M | 1.9M | $1.06 |
| Centers Lab Nj Llc | Clinical Laboratory | NJ | $1.8M | 1.6M | $1.09 |
| Heritage Lab Express Inc | Clinical Laboratory | IL | $1.6M | 1.4M | $1.09 |
| Advanced Clinical Laboratories, Inc. | Clinical Laboratory | FL | $1.5M | 1.4M | $1.06 |
| Myonsite Diagnostic Lab | Clinical Laboratory | CA | $1.5M | 1.4M | $1.08 |
| Laboratory Of Florida Llc | Clinical Laboratory | FL | $1.5M | 1.3M | $1.09 |
| Clinical Laboratory Services, Inc. | Clinical Laboratory | GA | $1.3M | 1.2M | $1.09 |
| Kan-Di-Ki Llc | Clinical Laboratory | NV | $1.3M | 1.2M | $1.09 |
| Victoria Healthcare Resources | Clinical Laboratory | LA | $1.1M | 1.1M | $1.04 |
| U S Lab & Radiology Llc | Clinical Laboratory | MA | $1.1M | 1.0M | $1.09 |
| Quality Clinical Lab Llc | Clinical Laboratory | FL | $1.0M | 1.0M | $0.98 |
| Professional Healthcare Inc | Clinical Laboratory | IL | $973.2K | 894.7K | $1.09 |
| Mako Medical Laboratories, Llc | Clinical Laboratory | NC | $925.0K | 853.4K | $1.08 |
| Precision Labs Llc | Clinical Laboratory | MO | $829.3K | 760.3K | $1.09 |
| Unique Lab Services, Llc | Clinical Laboratory | AZ | $749.9K | 692.9K | $1.08 |
| Four Tech Laboratory Llc | Clinical Laboratory | CA | $740.7K | 674.1K | $1.10 |
| Reliant Scientific Llc | Clinical Laboratory | FL | $712.5K | 655.0K | $1.09 |
The data suggests significant pricing inconsistencies for CPT P9603. With a 6.0x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have risen 19.1% since 2014, outpacing inflation and raising questions about whether reimbursement rates reflect actual costs.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.