The Centers for Medicare & Medicaid Services (CMS) has delayed by 60 days the enforcement of reporting requirements for clinical diagnostic laboratory tests under the Medicare Clinical Laboratory Fee Schedule (CLFS).

Under a final rule released in 2016, certain labs — including hospital outreach labs that have their own national provider identifier — must report private payer rate and volume data if they:

  • have more than $12,500 in Medicare revenue related to lab services under the CLFS; and
  • receive more than half of their Medicare revenue during a data collection period from lab and physician services.

The delay comes after CMS received feedback from industry stakeholders expressing concern about the original March 31, 2017, deadline for data submission. Labs now have until May 30 to submit the necessary data.

The 60-day delay is the maximum amount of time CMS can allow and still have adequate time to calculate CLFS payment rates scheduled to take effect on Jan. 1, 2018.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.