Medicare Payments for Clinical Diagnostic Laboratory Tests in 2016: Year 3 of Baseline Data

Beginning in 2018, the Medicare program will change the way it sets payment rates for clinical diagnostic laboratory tests (lab tests) under Part B. CMS will replace current payment rates with new rates based on current charges in the private health care market. This is the first reform in 3 decades to Medicare's payment system for lab tests. As part of the same legislation reforming Medicare's payment system, Congress mandated that OIG monitor Medicare payments for lab tests and the implementation and effect of the new payment system for lab tests. This data brief provides the third set of annual baseline analyses of the top 25 lab tests.