What the RESULTS Act Means for Genetic Testing Lab Revenue in 2027
Short answer: The RESULTS Act (H.R. 5269 / S. 2761) is bipartisan legislation that would replace PAMA's lab-reported pricing data with comprehensive commercial claims data and, per ADLM, hold Medicare lab fee schedule rates at current levels through 2028. It has not passed. Until it does, genetic testing labs should plan around CMS's preliminary CY2027 cuts.
Genetic testing labs are facing a split-screen planning problem. CMS has already posted preliminary CY2027 Clinical Laboratory Fee Schedule (CLFS) rates built under the Protecting Access to Medicare Act (PAMA), while Congress is weighing a bill that would change how those rates are set. This article explains what the RESULTS Act would do, what the CMS numbers show, and how molecular labs and their revenue cycle teams can plan without betting on a vote. For the rate-by-rate detail, see our analysis of the preliminary CY2027 rates for molecular pathology.
What is the RESULTS Act?
The Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act of 2025 was introduced as H.R. 5269 in the House and S. 2761 in the Senate. According to ARUP Laboratories' September 22, 2026 statement, it would replace PAMA's current reporting system with comprehensive, representative commercial claims data so CMS can set more accurate rates, while reducing reporting burden and mitigating steep payment reductions. ARUP reports support from more than 130 bipartisan members of Congress and nearly 70 patient and provider organizations.
The Association for Diagnostics and Laboratory Medicine (ADLM) describes the bill as changing how Medicare collects market data, reducing reporting burden, improving payment stability, and holding CLFS rates at current levels through 2028 while a new reporting system is implemented. ADLM's August 28, 2026 article does not report committee action, votes, or passage, and we have found no source showing the bill has been enacted.
Why the push for reform now?
The urgency comes from the CMS preliminary CY2027 rates, posted September 21, 2026. CMS reports 1,947 applicable HCPCS codes, of which 1,528 had a weighted median calculated from private payor data. Of those, 1,171 codes are priced lower than CY2026, 169 are equal, and 186 are higher. The average potential change from CY2026 rates is about 16% lower.
The reporting base is also a central argument. CMS says 6,411 laboratories submitted data covering January 1 through June 30, 2025. The American Clinical Laboratory Association (ACLA), as cited by ARUP, argues the rates rely on data from a small fraction of participating labs and that more than 20% of lab test codes had no reported commercial payment data. Reform advocates say that is exactly the gap a claims-based approach is meant to close.
How exposed are genetic testing codes?
Genetic testing is among the most heavily affected areas. CMS shows the preliminary weighted rate change for genomic sequencing (42 codes) at 23% lower and molecular pathology (211 codes) at 22% lower. Proprietary Laboratory Analysis (PLA) codes (151 codes) show a much smaller 2.4% reduction.
Payment for a test cannot fall more than 15% in a year under the statutory phase-in, which runs from CY2027 through 2029. ARUP reports that nearly 1,200 tests would see lower Medicare payments and that 775 would take the maximum 15% reduction in 2027, with further reductions possible in 2028 and 2029. Because the cap limits each year's drop, a 22% or 23% target does not land all at once. It phases in over multiple years if the law stays as written. Our earlier piece on the 2027 PAMA rate cuts covers the mechanics of the phase-in.
What is the timeline from here?
CMS's fact sheet lists the data collection period (January through June 2025), the reporting window (May 1 through July 31, 2026), and a public meeting on tests with no applicable information on September 15 and 16, 2026. Final CY2027 rates are slated for November 2026, and new rates take effect January 1, 2027.
That leaves a narrow legislative window. Congress would have to act before the January 1 effective date to change CY2027 outcomes. Whether Congress acts is not something any lab can control, which is why planning should not hinge on it.
How should labs and RCM teams plan?
First, build two revenue cases. Model your genetic testing volume at current CLFS rates and again at the preliminary CY2027 rates, applying the 15% annual cap per code. Keep a third scenario in view in case the RESULTS Act or a delay changes the baseline.
Second, tighten the front end. When per-test payment falls, denials and rework cost more as a share of margin. Medical necessity documentation, prior authorization status, and correct ICD-10 linkage should be right before the specimen is run. Our guide to genetic testing denials outlines the most common failure points.
Third, check code-level exposure. Rates differ across the 1,947 codes, and PLA codes behave differently from molecular pathology and genomic sequencing codes. Identify which of your top-volume CPT and PLA codes sit in the steepest categories, and prioritize payer contract review for those.
Fourth, track the calendar. Watch for the final CY2027 rate publication in November and any floor action on H.R. 5269 or S. 2761. Platforms such as ScreenMyGene can help centralize order-level documentation and coverage checks so that appeals and denials are caught earlier, but the underlying financial planning remains a lab leadership decision.
Frequently asked questions
Has the RESULTS Act passed?
No source we reviewed shows enactment. ADLM's August 28, 2026 article reports no committee action, votes, or passage. Labs should treat it as pending legislation and monitor Congress.gov for H.R. 5269 and S. 2761 rather than assume relief.
What would the RESULTS Act change about CLFS pricing?
Per ARUP and ADLM, it would replace PAMA's current reporting system with comprehensive commercial claims data, reduce reporting burden, and hold CLFS rates at current levels through 2028 while a new reporting system is implemented.
How much could genetic test payments fall under current law?
CMS's preliminary CY2027 data show genomic sequencing codes 23% lower and molecular pathology codes 22% lower on a weighted basis. A 15% annual cap applies, with the phase-in running from CY2027 through 2029.
When will final CY2027 rates be published?
CMS states final CY2027 CLFS rates will be published in November 2026, and new rates take effect January 1, 2027. Labs should model both preliminary and final figures once released.
Should labs wait for Congress before changing forecasts?
No. Because legislative outcomes are uncertain, build forecasts on current law and treat any RESULTS Act relief as upside. Revisit the model when final rates post or the bill advances.
This article is for educational and informational purposes only and is not legal, financial, coding, or medical advice. Laboratories should consult qualified counsel, compliance, and billing professionals about their specific situation.
Sources: CMS, Preliminary Calendar Year 2027 Medicare CLFS Payment Rates fact sheet (Sept. 21, 2026); ARUP Laboratories press release (Sept. 22, 2026); ADLM, "ADLM Continues Push for Permanent PAMA Reform" (Aug. 28, 2026); ADLM, "ADLM endorses the RESULTS Act" (Nov. 2025); 360Dx, "Congress Considers RESULTS Act in Positive Sign for PAMA Reform."