CMS Publishes Updates to the Clinical Laboratory Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) announced the following updates to the Clinical Laboratory Fee Schedule (CLFS):

• The next data reporting period is Jan. 1, 2026, to March 31, 2026.
• New proprietary lab analyses codes will be effective July 1, 2025.
• Six CPT codes will be deleted effective July 1, 2025: 0240U, 0241U, 0369U, 0370U, 0373U, and 0374U.
• Preliminary gapfill rates were published for the CLFS. CMS is accepting comments on these rate recommendations until June 28. All comments can be sent to clfs_inquiries@cms.hhs.gov.

The annual public meeting for the CLFS will take place on June 27, 2025, in Baltimore and online. Register here by May 29 to present or attend in person. CMS intends to publish all proposed determinations for new test codes and proposed determinations for reconsidered codes for calendar year 2026 by early September 2025, with comments in response to these proposed determinations accepted until early October 2025.

Sources:

https://www.cms.gov/training-education/medicare-learning-network/newsletter/2025-05-01-mlnc#_Toc196832455

https://www.cms.gov/files/document/mm14055-clinical-laboratory-fee-schedule-laboratory-services-subject-reasonable-charge-payment-july.pdf

https://www.govinfo.gov/content/pkg/FR-2025-04-21/pdf/2025-06756.pdf