Attachment 5 - Pathology Schedule of Services_09282026.xlsx

This is a pathology schedule of services pricing template for a federal contract opportunity with the Department of Veterans Affairs Nebraska-Western Iowa Health Care System. The document serves as an Excel-based pricing submission tool for contractors bidding on offsite pathology services (Solicitation Number 36C26326R0063).

The template requires offerors to populate laboratory information for any facilities performing tests under subcontract, identified by performing lab numbers (0-26), including laboratory name, physical address, CLIA number, and laboratory director contact information. For self-performed tests, offerors use lab number "0." The pricing schedule is organized into multiple sections covering fiscal years 2027 and 2028, with separate tabs for Profee_CMS OP1, CLIA OP1, Profee_CMS OP2, and CLIA OP2 operational periods. Each section contains hundreds of CPT/HCPCS codes spanning clinical pathology, molecular pathology, cytopathology, chemistry, hematology, coagulation, immunology, microbiology, and genetics testing. Offerors must indicate the performing laboratory for each test (by lab number), provide estimated quantities, unit pricing for contract services, CMS discount rates, and total contract pricing. The template includes an example pricing entry showing $100.00 pricing at 100% CMS rate. All pricing fields currently display $0.00, requiring contractor completion. The document emphasizes compliance with requirement DC 02.03.01 and indicates that pricing should reference CMS amounts with applicable discount rates for both send-out and in-house special pricing scenarios.