CMS Announces Phased-In Reduction of Medicare Payment Rates for Lab Services

The Centers for Medicare & Medicaid Services (CMS) plans to reduce preliminary Medicare payment rates for laboratory services.

In a Sept. 21 press release, CMS revealed its plans to align the 2027 Clinical Laboratory Fee Schedule (CLFS) rates with private sector payment rates, estimating taxpayer savings of $1 billion annually.

CMS has released preliminary data collected from laboratories that will be used to determine the preliminary 2027 Medicare payment rates for laboratory services. The agency states these data demonstrate that Medicare has been paying nearly 16 percent more for laboratory services than private payers.

Because Medicare payment for a clinical diagnostic laboratory test (CDLT) cannot legally be reduced by more than 15 percent per year through 2029, CMS will be gradually phasing in its reductions.

Public comment will be open for 30 days on the preliminary Calendar Year (CY) 2027 CLFS rates and supporting data. Final CY 2027 payment rates for CDLTs under the CLFS will be available in November 2026, with an effective date of Jan. 1, 2027.

Source:

https://www.cms.gov/newsroom/press-releases/cms-announces-new-preliminary-medicare-payment-rates-laboratory-services-saving-taxpayers-estimated