LigoLab Examines Potential 2027 Medicare Laboratory Reimbursement Cuts and Their Implications for U.S. Laboratories

GLENDALE, CA, Nov. 12, 2026 (GLOBE NEWSWIRE) -- LigoLab is examining the potential effects of Medicare laboratory reimbursement changes scheduled to begin in 2027, outlining how clinical laboratories and pathology practices can assess their financial exposure as federal policymakers consider changes to Medicare payment policy. The company’s announcement addresses the implications of the Protecting Access to Medicare Act (PAMA), the proposed RESULTS Act, and operational steps laboratories can consider ahead of the scheduled changes.

Clinical laboratories can prepare for potential 2027 Medicare payment cuts by reviewing test-level profitability, improving billing, and automating routine workflows.

“Laboratories need a clear understanding of how potential Medicare reimbursement changes could affect their individual testing services and overall operations,” said Suren Avunjian, Co-Founder and CEO of LigoLab. “Reviewing reimbursement by test code, examining billing processes, and evaluating existing technology infrastructure are important considerations as laboratories prepare for the 2027 changes. The objective is to understand potential financial exposure and identify areas that may require operational attention.”

The Centers for Medicare & Medicaid Services (CMS) released preliminary data on September 21, 2026, to inform the setting of 2027 rates under the Clinical Laboratory Fee Schedule (CLFS). The data show that preliminary weighted median private-payer rates for 1,171 of 1,528 laboratory test codes, or about 77%, were below the corresponding 2026 Medicare rates. These figures are preliminary benchmarks for establishing 2027 payment rates; they do not indicate that every test will receive the same reduction.

Under the current phase-in schedule, Medicare payment for an individual test can decrease by up to 15% per year from 2027 through 2029. The first phase of the schedule is set to begin January 1, 2027. The actual effect on a laboratory will depend on its test mix, Medicare reimbursement levels, and the volume of services it provides.

Lower payments may place pressure on operating budgets and influence decisions involving staffing, equipment, testing capacity, and the range of services a laboratory can sustain.

For that reason, an organization-wide estimate may not show where exposure is concentrated. Reviewing reimbursement by test code can provide a more detailed picture of which services account for the largest share of Medicare revenue and where changes may have the greatest financial effect.

The potential implications also extend to providers and patients who rely on laboratory testing as part of diagnosis, treatment decisions, and ongoing care. If financial pressure leads a laboratory to reconsider certain services or its testing capacity, access could be affected.

An example illustrates the possible scale. A laboratory that receives $5 million annually from Medicare could lose $500,000 in annual revenue if its payments fell by an average of 10%, assuming its testing volume and mix remained unchanged. This is an illustration, not a forecast.

The proposed RESULTS Act is also part of the policy discussion surrounding laboratory payment. Until changes are enacted, laboratories must plan around the current statutory phase-in schedule.

Five Steps Laboratories Can Take Now

LigoLab’s announcement identifies five areas that laboratory leaders can review as they prepare for the scheduled changes.

First, laboratories can estimate potential revenue losses by test code. Comparing current Medicare reimbursement with preliminary payment benchmarks can help identify services that may account for a larger share of possible reductions. The analysis should reflect each laboratory’s testing volume and mix rather than applying one percentage across all services.

Second, leaders can review the profitability of individual tests. Examining test-level economics can help management understand which services may warrant closer review as reimbursement changes take effect.

Third, laboratories can examine billing accuracy and recurring claim denials. Coding errors, incomplete information, and repeated submission problems can complicate payment processes. Reviewing denial patterns and the reasons claims are not paid as expected can help identify issues within existing billing workflows.

Fourth, organizations can assess repetitive laboratory and administrative workflows for opportunities to automate routine tasks. Manual processes may require staff time across operational and billing functions. Reviewing where work is repeated or where information must be handled more than once can help identify processes suitable for automation.

Fifth, laboratory leaders can evaluate whether their laboratory information system (LIS) meets operational and reporting needs. That review may include how the system supports laboratory workflows, billing activities, data handling, and access to financial information.

LigoLab provides an integrated Laboratory Information System (LIS) and Revenue Cycle Management (RCM) platform that connects laboratory operations with billing. The platform’s functions include workflow automation, pre-submission claim checks, and reimbursement dashboards.

Workflow automation can address repetitive tasks in laboratory operations. Pre-submission claim checks provide a review point before claims are sent, while reimbursement dashboards give users visibility into payment information. Together, these functions relate laboratory activity to billing processes and can help organizations review manual work and identify payments that may require follow-up.

The approaching implementation date makes the review of test-level reimbursement, service costs, billing processes, and information systems a timely management consideration. Laboratories will need to follow official payment updates as the 2027 rates are established.

Through this announcement, LigoLab is drawing attention to the potential operational and financial implications of the 2027 Medicare laboratory reimbursement changes and the steps laboratories can consider while the policy framework develops.

For additional information about LigoLab's integrated laboratory information system and revenue cycle management platform, visit https://www.ligolab.com/.

About LigoLab

LigoLab is a healthcare technology company based in Glendale, California. It provides an integrated Laboratory Information System (LIS) and Revenue Cycle Management (RCM) platform that connects laboratory operations with billing processes.

Media Contact
Company Name: LigoLab
Contact Person: Michael Kalinowski, Marketing & Communications
Email: marketing@ligolab.com
Phone: (800) 544-6522
Country: United States
Website: https://www.ligolab.com/

Media Contact
Company Name: LigoLab
Contact Person: Michael Kalinowski, Marketing & Communications
Email: marketing@ligolab.com
Phone: (800) 544-6522
Country: United States
Website: https://www.ligolab.com/