On February 3, 2026, Section 6226 of the CAA, 2026 was passed and updated the data reporting requirements for clinical diagnostic laboratory tests (CDLTs) that are not advanced diagnostic laboratory tests (ADLTs). It also delayed the phase-in of payment reductions under the CLFS from private payor rate implementation.
The next data reporting period will be May 1, 2026 through July 31, 2026, based on an updated data collection period of January 1, 2025 through June 30, 2025. There is no phase-in reduction in 2026; beginning January 1, 2027 through 2029, payment may not be reduced by more than 15% per year compared to the payment amount established for a test the preceding year.
Visit the CMS Clinical Laboratory Fee Schedule reporting pages for specifics on PAMA regulations and to determine whether you qualify as an applicable laboratory.
Running the PAMA Report in SurroundLab AR
If you need to report private payor data and have not started running the PAMA Report to create your files and perform validation, now is a good time to begin. If installed at your site, the report is under Billing System > Management Reports > PAMA Reporting (menu 1,8,49). Payers, PAMA payer group mapping, transaction codes and CPTs may have been updated since the last required reporting period, so review configuration settings before running the report for 2026.
Updating PAMA HCPCS codes
In the CPT Edit menu option, the PAMA HCPS field must be present for the report to work correctly. Run the PAMA HCPCS update once every three years, as CMS may update the list of required codes. Download the CLFS Applicable Information HCPCS Codes file from the CMS site, re-save the Excel file as a tab-delimited text file and use it to update the PAMA HCPCS field in CPT Code Definition. The report sets PAMA HCPCS to YES for codes in the list; if you need to report a CPT under another CPT/HCPCS code, the optional PAMA Reporting HCPCS field supports that. Your Support Representative can assist and provide a user guide.