Medicare Releases October 2026 Quarterly Update to Its Lab Test Payment Schedule

The Centers for Medicare and Medicaid Services released the October 2026 quarterly update to the Clinical Laboratory Fee Schedule and associated Clinical Laboratory Improvement Amendments HCPCS codes, as noted in the August 27, 2026 MLN Connects newsletter. The update adds new billing codes for laboratory tests and removes codes no longer in use, with an effective date in October 2026.

Medicare publishes four quarterly updates to the Clinical Laboratory Fee Schedule each year, in January, April, July, and October, to keep payment codes aligned with changes in diagnostic test technology and coding standards. New codes added in a quarterly update are initially priced by individual Medicare Administrative Contractors until they complete the formal annual payment determination process, which establishes nationally standardized rates.

Services covered under the fee schedule include blood chemistry panels, complete blood counts, urinalysis, tissue pathology, microbiology tests, and other diagnostics. Most covered laboratory services ordered by a treating provider carry no beneficiary copayment under Original Medicare.

Correct coding is essential for laboratory claims to process without error. Laboratories, billing offices, and ordering providers should verify that their systems reflect the updated HCPCS code set before submitting October claims.