CodeMap® Briefing: 05/16/2025

Editor's Welcome: 

The Congressional Budget Office is revising the forecasting model used for estimating Medicare's Clinical Laboratory Fee Schedule payments. Because the new model recognizes that private insurers rarely adjust lab prices for inflation, another 12-month freeze on PAMA-driven cuts in 2026 may no longer score as federal savings, removing the incentive for Congress to extend the freeze. Without passage of a “PAMA-fix” bill before year-end, laboratories could face rate reductions of up to 15% on tests beginning January 1, 2026. Below, our friends at Laboratory Economics discuss in detail.

As always, please s....

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