On Aug. 17, the Centers for Medicare & Medicaid Services (CMS) released its quarterly update to the Clinical Laboratory Fee Schedule (CLFS) and those laboratory services subject to reasonable charge payment.
The next CLFS data reporting period for clinical diagnostic laboratory tests (CDLTs) has been delayed until Jan. 1 to March 31, 2024. This delay does not include advanced diagnostic laboratory tests. After the next data reporting period, CMS is implementing a three-year data reporting cycle for CDLTs starting in 2027. Reporting entities must give CMS certain private payer rate information for their component applicable laboratories. Additionally, the statutory phase-in of payment reductions resulting from private payer rate implementation is extended through 2026. CMS will not reduce payment by more than 15 percent for 2024 through 2026.
CMS also finalized an increase to the nominal fee for specimen collection based on the Consumer Price Index for all Urban Consumers (CPI-U). For 2023, the general specimen collection fee increased from $3 to $8.57. For those specimens collected from Medicare patients at skilled nursing facilities or by a laboratory on behalf of a home health agency, the specimen collection fee has been increased to $10.57. This fee amount will be updated annually by a percent change in the CPI-U.
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