Effective May 1, clinical diagnostic laboratories will be required to follow new data reporting requirements for clinical diagnostic laboratory tests that are not advanced diagnostic laboratory tests.
All independent, physician office, and hospital outreach laboratories that meet the definition of “applicable laboratory” under the Clinical Laboratory Fee Schedule (CLFS) will be subject to a data reporting period from May 1 to July 31, 2026, for the updated data collection period of Jan. 1 to June 30, 2025. This data collection period was updated according to language in Section 6226 of the Continuing Appropriations Act (CAA) of 2026, which was passed on Feb. 3, 2026.
The following data must be reported:
Another provision of the CAA delayed the phase-in of payment reductions under the CLFS from private payer rate implementation. Starting Jan. 1, 2027 to 2029, payment may not be reduced by more than 15 percent per year compared with the amount established for a test during the preceding year.
Sources:
https://www.cms.gov/medicare/payment/fee-schedules/clinical-laboratory-fee-schedule-clfs