CMS Posts Preliminary 2027 Medicare Lab Payment Rates, Projects 1 Billion Dollars in Annual Savings

The Centers for Medicare and Medicaid Services on September 21 released preliminary payment rates for the Calendar Year 2027 Medicare Clinical Laboratory Fee Schedule, which covers most blood, urine, and molecular tests ordered for Medicare patients. CMS projects the changes would save taxpayers about 1 billion dollars annually by bringing Medicare's reimbursement rates closer to what private insurers pay for the same tests. According to the agency, Medicare currently pays approximately 16 percent more than private payers for comparable laboratory work.

The preliminary data covers roughly 1,947 billing codes. Of the 1,528 codes with data from private-payer surveys, about 1,171 face lower proposed rates, 186 would see increases, and 169 would remain unchanged. Proposed reductions vary by test type: chemistry tests face an average cut of about 16 percent, molecular pathology about 22 percent, and genomic sequencing about 23 percent.

Federal law caps laboratory payment reductions at 15 percent per year, so cuts larger than that will be spread over multiple years, with the phase-in running through 2029.

CMS is accepting public comment on the preliminary rates for 30 days from September 21, with final rates expected in November 2026 and effective January 1, 2027. Medicare beneficiaries generally pay no coinsurance on covered preventive lab tests, though cost-sharing for diagnostic lab work varies by how care is delivered.