CMS released a preliminary clinical lab fee schedule in September that would cut payment on 775 tests by 15 percent for 2027. Labcorp puts the hit at $125 million. Quest Diagnostics puts its own at roughly 1 percent of 2026 revenue. Both chief executives spent part of their third quarter calls on October 30 asking Congress to pass the RESULTS Act instead.
The bill would have CMS contract an independent nonprofit commercial claims database to set lab rates. That displaces the PAMA data collection, which the American Clinical Laboratory Association says overstates how much of the market independent labs hold. Congress has delayed PAMA cuts six times. Labs reported data a second time in 2026. The trade group says further reductions follow in 2028 and 2029.
The Congressional Budget Office is scoring the bill against the PAMA cuts, with a number expected in November. Quest CEO Jim Davis said the primary House and Senate committees would convene after the score, with the goal of attaching the Act to a year end spending package. Congress returns for a lame duck session after the midterms. CMS plans to finalize 2027 rates in November.
For a diagnostics startup, the fee schedule is the revenue model. A 15 percent cut on the code your assay bills under moves a reimbursement assumption further than most of the clinical data you will generate next year.