The Centers for Medicare & Medicaid Services released a proposed rule for the 2027 Medicare Physician Fee Schedule and other Medicare Part B issues for calendar year (CY) 2027. The proposed rule also includes provisions related to the Clinical Laboratory Fee Schedule (CLFS).
CMS is proposing regulatory changes to implement the Consolidated Appropriations Act amendments affecting the Medicare CLFS. These changes would update the requirements for data collection and data reporting and the phase-in of payment reductions for clinical diagnostic laboratory tests (CDLTs) paid under the CLFS.
The next data reporting period for CDLTs that are not advanced diagnostic laboratory tests (ADLTs) is scheduled from May 1, 2026, through July 31, 2026, based on information collected from Jan. 1, 2025, through June 30, 2025. Beginning in CY 2027, CMS is proposing that payment reductions from the implementation of CLFS payments based on private payer rate data would be subject to a phase-in reduction of up to 15 percent per year through CY 2029.
Additionally, CMS is issuing a request for information on duplicate laboratory testing, imaging, and result sharing and interoperability. The agency is seeking input from stakeholder laboratories, health systems, payers, and other interested parties to prevent issues with delayed or incomplete care management, duplicative testing, increased program costs, and other concerns.
The deadline to submit comments is Sept. 14, 2026.
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