CHA News Article

CMS Issues Preliminary CY 2018 Clinical Lab Fee Schedule Rates
Comments are due Oct. 23

The Centers for Medicare & Medicaid Services (CMS) has issued its preliminary Medicare payment rates for clinical diagnostic laboratory tests and advanced diagnostic laboratory tests paid under the clinical lab fee schedule (CLFS) in calendar year (CY) 2018. As required by the Protecting Access to Medicare Act of 2014, the rates are based on a weighted median of private insurer payment rates paid to applicable laboratories. Additional information on the definition of applicable laboratories for reporting purposes is available in the final rule issued in June 2016. CMS estimates the new CLFS payment rates will reduce Medicare Part B spending by $670 million in CY 2018.

CMS is accepting comments on the preliminary payment rates until Oct. 23. Comments can be submitted at The CMS summary of data reporting of the private payer rates is attached. CMS will make the final CLFS payment rates available in early November.