Reimbursement Landscape in 2026 and Beyond

Pathology reimbursement in the US has faced sustained and accelerating declines over the past two decades. How can pathologists reduce denials and protect revenue while maintaining the same high quality of care?

The CAP Practice Management Committee is pleased to host “The Reimbursement Landscape in 2026 and Beyond,” featuring speakers with deep experience in pathology and laboratory reimbursement across hospital, independent, and reference laboratory settings. This session will focus on the current reimbursement landscape, emerging payer trends, and the most common pressure points affecting pathology practices.

Participants will gather practical insights on how to better align clinical decision-making, documentation, and billing practices with evolving payer requirements to avoid claim denials and keep revenue stable.

Objectives:

• Understand how reimbursement is affected by payer policy interpretation, prior authorization requirements, heightened scrutiny of documentation, and more.
• Identify how payer AI and data-driven algorithms influence coding, medical-necessity determinations, and claim outcomes.

Moderators:
Ann Lambrix, Executive Director, Lighthouse Lab Services
Robin Miller Zweifel, BS, MLS(ASCP), Director of Coding Operations and Payer Strategy, XiFin, Inc.

Panelists:
Rebecca Obeng, MD, PhD, MPH, FCAP
Tamera A. Paczos, MD, FCAP