CMS releases preliminary 2027 Clinical Laboratory Fee Schedule rates
Oct 11, 2026 edition · GC-2026-0132 · Published 2026-10-11 · Version 3 · Proposed
CMS opens October 21 feedback on 2027 laboratory payments through two different processes: comments on preliminary new-test determinations and reconsideration of final MAC gapfill recommendations. The distinction affects which evidence and submission route laboratories should use.
What happened
The September 24 newsletter directs laboratories to preliminary calendar-year 2027 determinations for new tests and invites comments by October 21. Those determinations remain part of the annual rate-setting process. CMS identifies [email protected] as the comment address, making this a prospective opportunity to support a payment position rather than a statement that every proposed amount is already final.
The same notice separately links final 2026 Medicare Administrative Contractor gapfill recommendations for calendar-year 2027. Requests to reconsider those payment recommendations go to [email protected] by October 21. CMS says the gapfilled amount becomes final once the final, complete 2027 fee schedule is posted. A laboratory reviewing both files therefore needs to distinguish comments on a preliminary new-test determination from reconsideration of a MAC gapfill recommendation; the shared deadline does not make the two stages interchangeable.
Scope and timing
- Authority status
- Proposed
- Applicability
- Directly applicable
- Audience
- Health systems, Provider networks
- Jurisdiction
- Federal
- Affected functions
- Clinical Operations, Revenue Cycle, Finance, Compliance
- Responsible owner
- Revenue Cycle
- Recorded date
- 2026-10-21
- Date type
- comment
Why it matters
Laboratories need to model rate effects and identify codes for which CMS should receive evidence before the comment window closes.
Recommended action
Model the preliminary rates against current volume, identify material changes, and submit supported comments or reconsideration requests by October 21.
Implementation playbook
- Model preliminary rates against current laboratory volume. Finance · Due 2026-10-05
- Identify codes needing comment or reconsideration and assemble support. Clinical Operations · Due 2026-10-12
- Submit any supported request before the CMS deadline. Revenue Cycle · Due 2026-10-21
Sources
- MLN Connects Newsletter, September 24, 2026Official · Centers for Medicare and Medicaid Services · 2026-09-24 · Source review 2026-10-11
Complete edition and supplemental material
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