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R13855CP: July 2026 Quarterly Update to the Clinical Laboratory Fee Schedule (CLFS) and ClinicalLaboratory Improvement Amendments (CLIA): Healthcare Common Procedure Coding System(HCPCS) Codes, Waived Tests, and Reasonable Charge Payments.
Medicare/CMS - Transmittals·CMS Transmittal
We identified it
Jul 3, 2026
Summary
CRITICAL MISMATCH DETECTED: The policy title references R13855CP regarding July 2026 Clinical Laboratory Fee Schedule updates and HCPCS codes for laboratory testing. However, the actual document content provided is unrelated marketplace help desk contact information and agent/broker registration resources dated May 2024. The billing team cannot act on this policy because the actual fee schedule details, affected HCPCS codes, and reimbursement changes are not included in the provided content.
Action Required
IMMEDIATE ACTION REQUIRED: Billing team must obtain the complete R13855CP policy document from CMS. The document provided contains only administrative contact information, not the actual Clinical Laboratory Fee Schedule updates. Contact CMS directly at the provided help desk email or visit https://www.cms.gov/medicare/regulations-guidance/transmittals/2026-transmittals/r13855cp to retrieve the full policy text containing specific HCPCS code changes, fee schedule adjustments, and waived test updates. Do not implement any billing changes until the complete policy is reviewed. This July 2026 update will likely affect laboratory billing codes and reimbursement rates—delay in obtaining the full policy could result in incorrect claim submission.