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CMS lays out CLFS timeline, data deadlines and public comment process at annual meeting
Summary
CMS officials opened the Clinical Laboratory Fee Schedule annual public meeting, reviewed statutory requirements and recent Consolidated Appropriations Act changes, announced data‑reporting and panel dates, and outlined the crosswalk/gap‑fill timing and public comment windows for CY2027 CLFS determinations.
Rashida Arthur, a member of the Medicare clinical laboratory fee schedule policy team, opened the Centers for Medicare & Medicaid Services annual Clinical Laboratory Fee Schedule (CLFS) public meeting and reviewed meeting logistics, time limits and the public comment process. She reminded participants that the meeting covers only the codes listed in CMS’s CLFS CY 2027 test code updates file and that presentations are limited to 10 minutes with a five‑minute question period.
Natalie Dayal, acting deputy director of the hospital and ambulatory policy group, summarized the legal and procedural framework for the CLFS process, citing Section 1834af3 of the Social Security Act as the statutory basis for the public meeting. She told attendees that CMS is in the current data‑reporting window, which opened May 1 and closes July 31, 2026, and that the agency will post preliminary payment determinations in late September or early October and accept public comments for 30 days after posting. Dayal also noted the advisory CDLT panel meeting dates: July 14–15 (panel meeting) and a second set of public and FACA panel meetings Sept. 15–16.
Arthur emphasized procedural points for stakeholders: CMS will accept reconsideration requests following final determinations, Medicare contractors (MACs) will post preliminary gap‑fill rates online, and MAC‑specific gap‑fill pricing will be developed by April 30 of the final year and finalized by Sept. 30. "The CLFS annual public meeting provides an opportunity for the public to present and comment on the appropriate basis for establishing payment amounts for new or substantially revised HCPCS codes," Arthur said.
CMS will publish preliminary determinations after considering public presentations, comments, and the CDLT panel’s recommendations, and will accept a 30‑day public comment period on those preliminary determinations. Where gap‑fill pricing is used, MACs will develop contractor‑specific amounts; CMS will post those amounts and accept reconsideration on the posted gap‑fill amounts for 30 days.
Next steps: stakeholders may submit questions and supporting materials to the CLFS annual public meeting resource mailbox noted during the session; CMS indicated follow‑up and additional information will be posted on the CMS CLFS public meeting web page.
