The Centers for Medicare and Medicaid Services (CMS) recently released preliminary Medicare clinical laboratory fee schedule (CLFS) payment rates for calendar year 2027.  

The preliminary rates are based on the weighted median rates reported for private payers for certain laboratory tests and are estimated to cut Medicare fee-for-service (FFS) CLFS payments to Michigan providers by approximately $7 million in 2027. The 2014 Protecting Access to Medicare Act (PAMA) required the CMS to collect private payer rates to ensure that Medicare rates do not exceed such rates. The preliminary rates are based on data collected for the period Jan. 1 to June 30, 2025, reported by July 31, 2026.  

Providers are encouraged to review the preliminary rates during the 30-day review period and submit comments to CMS by Oct. 21.  Final 2027 rates are expected to be released in November.  

The American Hospital Association, the MHA and others are concerned that the 2027 preliminary rates would impose cuts of up to 15% on almost 1,200 laboratory tests on the Medicare CLFS based on incomplete commercial market data. Members with questions should contact the MHA health finance department. 

Phone: (517) 323-3443
Fax: (517) 323-0946

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Fax: (517) 703-0628