Physicians May Face Lower Payment as CMS Resumes Lab Data Collection

The Clinical Laboratory Improvement Act (CLIA) allows CMS to regulate all laboratory testing (except research) done in U.S. physician offices and other health care facilities. As an ongoing requirement of that law, CMS collects laboratory data from physicians.

In November, Congress delayed the data-reporting requirements for certain clinical diagnostic laboratory tests (CDLTs) and the phase-in of payment reductions from private payers.

However, CMS recently announced it will resume data collection on Jan. 1, 2025. The agency also will require data from the original collection period of Jan. 1 to June 30, 2019.

CMS also extended the phase-in of payment reductions resulting from private payer rate implementation. While no payment reductions will occur in 2024, payment will be reduced between 2025 and 2027. CMS states it will apply a 0% payment reduction for 2024 and will not reduce payment more than 15% per year moving forward.it will apply a 0% payment reduction for 2024 and will not reduce payment more than 15% per year moving forward.

Source: Physicians May Face Lower Payment as CMS Resumes Lab Data Collection / Texas Medical Association

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