Medicare clinical laboratory rates

CMS Eyes Major Cuts in Medicare Clinical Lab Rates

Medicare payments for clinical laboratory services will soon be coming down. The Centers for Medicare & Medicaid Services is working to bring Medicare’s clinical laboratory services rates into line with those paid by commercial insurers. Asserting that Medicare is now paying 16 percent more for clinical lab tests than commercial payers, the agency has posted proposed rates for calendar year 2027 that reflect the beginning of what in some cases will be a multi-year process of aligning public and private lab payments – “aligning” by reducing Medicare payments. Hospital laboratories perform between 40 and 55 percent of laboratory tests. While [...]

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss various Medicare payment issues. Among the issues discussed at MedPAC’s April meeting were: Medicare skilled nursing facility value-based purchased program. Medicare alternative payment models (APMs). Medicare Advantage benchmark policy. Medicare indirect medical education (Medicare IME) payments. Medicare vaccine coverage and payments. Medicare payment for prescription drugs prescribed on an outpatient basis. Private equity and Medicare. Medicare clinical laboratory fee schedule. MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding on either Congress or the administration, MedPAC is [...]