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- Clinical lab data collection reporting starts May 1
Last week, Congress passed the Consolidated Appropriations Act of 2026, delaying the planned 2026 Medicare cuts to lab tests (up to 15%) until 2027. Clinical labs must now focus on upcoming programmatic requirements.
Zoom in: Certain laboratories must prepare to collect and send data to the government regarding the private payer rates they receive for tests. These data will then be used to calculate new fees for tests on Medicare's Clinical Laboratory Fee Schedule.
- The required data will be the rates clinical labs received for tests between January 1 and June 30, 2025.
- Laboratories are expected to send these data to the Centers for Medicare & Medicaid Services (CMS) between May 1 and July 31, 2026.
Yes, but: Laboratories should first assess if they meet the definition of an “applicable laboratory” under the revised rules.
Watch: Medicare Learning Network: Is My Lab an Applicable Lab?
What’s next: CMS will release resources and fact sheets to aid in data submission in the coming months.
- Labs should begin gathering the necessary data and assessing their readiness to meet new requirements.
Download: We’ve developed a two-page resource answering questions about the data collection and reporting process.
Looking ahead: The CAP will continue to ask Congress to minimize these administrative burdens on labs by passing RESULTS Act.