Under the final Medicare Clinical Laboratory Fee Schedule (CLFS) for 2014, released just before Thanksgiving, clinical laboratory tests will get a 0.75 percent negative update. When combined with the ongoing 2 percent reduction resulting from sequestration, lab fees will be cut a total of 2.75 percent beginning Jan. 1.This marks the fourth time in the last five years that the lab fee update has fallen into negative territory (see table below).The 2014 update is determined by a multipart statutory formula: the consumer price index for urban areas (1.8 percent) minus a productivity adjustment of 0.8, minus a 1.75 percentage point reduction required by the Patient Protection and Affordable Care Act. The 0.75 reduction is taken off of the 2013 CLFS rates. The 2 percent sequestration reduction is added on to this.Under current law, Medicare payment for clinical laboratory tests is scheduled to be reduced by 23 percent between 2010 and 2022 as a result of rebasing mandated by Middle Class Tax Relief and JobCreation Act of 2012 and the sequestration. This means that a test paid  at $10 in 2010 will be paid at $9.88 in 2022, according to the American Clinical Laboratory Association. If payment for this same $10…

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