CMS Issues Preliminary CY 2027 Medicare Clinical Laboratory Fee Schedule Payment Rates

As directed under the Protecting Access to Medicare Act of 2014, the Centers for Medicare & Medicaid Services must collect private payer rates from applicable laboratories, which would establish a market-based methodology used to calculate Medicare clinical laboratory fee schedule rates. CMS released information ahead of final rates that are expected to be shared in November, indicating that the new methodology would save Medicare $1 billion annually. CMS also projects that hospital-based and freestanding labs should prepare for rate decreases of 15% on hundreds of tests.