On November 25, 2025, CMS issued final lab test prices for new tests for CY2026.
###
They regularly come out during Thanksgiving week. It's the new-test lab test prices for CY2026.
Find the annual meeting page here and scroll down to "Meeting Notice" section and then scroll down to CLFS Test Code Payment Determinations for CY2026 Final.
Or this link should drop down the Zip file for you:
https://www.cms.gov/files/zip/cy-2026-final-payment-determinations.zip
What Happened
There were 93 agenda items, four of which were deleted from the process. Of the 90 active items, 75 were finalize as proposed and 14 were changed. 11 were changed from one crosswalk to another, 1 was changed from CW to GF, and two were changed from GF to CW.
20 codes go to "gapfill," all but onc was proposed as gapfill. That one code switched from CW to GF (as just noted).
Of 59 codes crosswalked, most were crosswalked to a single code x1.
Other crosswalks were fractional or multiple or additive. Only one was a fraction, 0094U x.5 for 0583U. I didn't see a positive fraction (like x1.25 or x1.5) which CMS nearly never uses. Three crosswalks were additive (e.g. to Code 1 + Code 2). There were a couple cases of crosswalk to a multiple (x2).
One code, 05239, was crosswalk to code 0022U minus 81449, the 'minus' function is extremely rare in crosswalks.
