On December 23, 2025, CMS released the final fee lab fee schedule (aka CLFS) for January 2026.
https://www.cms.gov/medicare/payment/fee-schedules/clinical-laboratory-fee-schedule-clfs/files
See file, "26CLABQ1" CY 2026 Q1.
There was just one notable change (Natera Signatera rate, $3920 falls to $3590).
Note, however, that many older lab tests (often routine clinical chemistry) were scheduled to fall up to 15% on January 1, delayed by legislation to January 31. Without further legislation, some conventional CLFS rates will fall in February and the rest of 2026.
Signatera
Signatera entered ADLT pricing at $3500, and rose as high as $3920 for CY2025. ADLT rates are based on the ADLT lab's commercial payor pricing, in this case, for 1HCY2024 submitted data to CMS in 1Q2025 effective as median price starting1Q2026. That is, Natera (I believe) would have known its January 2026 CLFS rate for its ADLT as soon as claims for 1H2024 were on the books.
Puneet Souda of Leerink noted, the pending new ADLT price "has been widely telegraphed and expected for nearly a year."
Experience Shows...
Often, or usually, ADLT prices are quite stable year to year (not even changing a penny). I believe the simplest interpretation is that Medicare Advantage plans are at least 51% of commercial volume and, such Medicare Advantage plans are paying the lab at the effective CLFS rate.