In this webinar, Jondavid Klipp (Laboratory Economics) and the NovoPath team unpack what 2026 will look like for pathology labs: Medicare fee schedule changes, looming clinical lab cuts, and, most importantly, the disconnect between real digital pathology adoption and the tiny 1.1% utilization CMS currently “sees.” You’ll learn why reporting digital pathology add-on codes matters, why it’s so hard today, and how NovoPath’s LIS-led approach automates reporting so labs can accelerate toward future reimbursement and AI-enabled efficiency.
Highlights
- Medicare sets the tone: 2026 Medicare pathology rates rise ~0.6% overall, with key changes to CPT 88305 and flow cytometry codes 88184/88185, while up to 800 clinical lab tests still face potential cuts of up to 15% starting Feb 1, 2026 if legislation doesn’t intervene.
- Digital pathology adoption is higher than CMS thinks: CMS digital pathology add-on codes show only ~1.1% utilization in 2024, almost certainly under-reported compared to real-world adoption.
- Catch-22: CMS won’t move digital pathology add-on codes into permanent, reimbursed Category 1 status until utilization looks “meaningful,” but labs have little incentive to do the extra reporting work today because there’s no current reimbursement and reporting is technically hard.
- Unique problem: Labs are digitizing slides, but LIS, digital viewers, and RCM often don’t talk to each other cleanly, making accurate, scalable reporting of digital add-on codes painful.
- NovoPath’s approach: NovoPath positions its LIS as a digital pathology reporting engine, integrating with major digital viewers, automatically identifying digitally-read cases, surfacing the correct CPT add-on codes, and pushing clean data into RCM systems so labs can:
- Accurately reflect digital utilization to CMS
- Reduce manual coding burden
- Support future reimbursement and AI-driven ROI
What this webinar covers
- 2026 Medicare reimbursement landscape for pathology & labs
- Significant increases for flow cytometry technical components (e.g., 88184 and 88185).
- Status of clinical laboratory fee schedule cuts (up to 15% for ~800 codes) and the temporary 30-day delay; how advocacy (ACLA, CAP, others) is working to reshape reporting and future rate-setting.
- Why Medicare’s rates matter: commercial payers, Medicare Advantage, and Medicaid plans largely benchmark against CMS.
- Digital pathology & Medicare: where things really stand
- CMS has created 43 digital pathology “monitoring” / add-on codes to track utilization of digitized slides across common surgical pathology codes (e.g., 88305, 88304, 88307, 88342…).
- Latest analysis from Laboratory Economics shows:
- ~179,892 reported digital add-on services across
- ~16.4 million eligible services → only ~1.1% “visible” digital adoption to CMS.
- Why this is misleadingly low: most labs aren’t reporting even when they’re reading cases digitally, because:
- Reporting requires non-trivial LIS and billing changes
- There is no immediate payment for the digital add-ons
- Staff and coding teams are already stretched thin
- The Catch-22 blocking digital pathology reimbursement
- CMS stance: They'll consider reimbursing for digitization once they see “meaningful” utilization but haven’t defined the exact threshold (5%? 10%+?).
- Reality today:
- Real-world digital pathology adoption is growing (especially in health systems, AMCs, and large commercial labs).
- CMS data still shows only ~1.1% utilization, leaving digital pathology below the radar for formal reimbursement.
- Net effect:
- Labs hesitate to invest further because reimbursement is uncertain.
- Reimbursement remains uncertain because labs aren’t reporting utilization.
- NovoPath’s solution to the reporting problem
NovoPath’s core perspective: “Your LIS should not just store data, it should actively help you prove digital adoption to CMS and payers without burning out your staff.”
In the webinar, NovoPath outlines how it tackles this unique problem:
- Deep integrations with major digital viewers
- Identify which cases are actually read digitally, not just which slides are scanned.
- Flag cases that are eligible for digital add-on codes (e.g., digital 88305).
- Automated digital add-on code assignment
- When a case is read digitally, the LIS automatically attaches the correct CPT digital add-on code based on the base CPT (88305, 88342, etc.).
- Removes the need for manual pathologist or coder review of every report just to determine if it was read digitally.
- End-to-end data flow into RCM systems
- Structured data flows from LIS → RCM cleanly, so billing systems can submit compliant claims with digital add-on codes included.
- Minimizes rework, denials, and missed opportunities to document utilization.
- Guidance, not just software
- NovoPath acts as a partner in digital transformation, not just a vendor:
- Helping labs interpret CMS rules and add-on code requirements
- Designing LIS workflows that fit each lab’s digital and AI strategy
- Providing real-world implementation examples that increase reporting rates
- Why digital pathology still makes sense even before reimbursement
The webinar also highlights current ROI for digital pathology, even without direct reimbursement for digitization:
- AI enablement: You can’t run AI without digitized slides. Once slides are digital, AI tools can:
- Pre-screen or triage cases
- Boost pathologist throughput (more slides per day)
- Support quality and consistency.
- Work-from-home & talent retention: Digital workflows allow pathologists to read slides remotely, even 1–2 days per week, an increasingly important recruiting / retention perk, especially for younger pathologists.
Commercial edge: Labs with end-to-end digital pathology often gain marketing, sales, and differentiation advantages in their markets.
Who should watch this webinar?
This session is especially relevant for:
- Pathology lab directors and practice leaders
- Pathologists championing digital pathology or AI in their organization
- Billing, coding, and RCM leaders in anatomic pathology
LIS / IT leaders responsible for integrating digital viewers, scanners, and revenue cycle systems
Frequently Asked Questions (addressed in the webinar)
A: On average, ~0.6% increase for pathology services, with specific updates for key codes like CPT 88305 and significant increases for certain flow cytometry technical components (88184, 88185). The impact will vary by lab and geography due to local adjustments.
A: Approximately 800 tests on the Medicare Clinical Laboratory Fee Schedule are currently scheduled for cuts of up to 15% starting Feb 1, 2026, subject to legislative changes. The webinar explains the 30-day delay and ongoing advocacy by ACLA, CAP, and others.
A: CMS first wants to see meaningful utilization of digital pathology documented through the 43 digital add-on codes. Current reported utilization (~1.1%) is too low to trigger reimbursement policy changes, and that low number is driven largely by under-reporting, not lack of real-world adoption.
A: Key reasons:
- Reporting is technically hard: requires LIS upgrades, digital viewer integration, and RCM alignment.
- There is no immediate payment for digital add-on codes, so labs see little short-term financial incentive.
- Manual workflows (reading reports, adding codes by hand) aren’t scalable for busy coding and billing teams.
A: CMS has not published a specific target (e.g., 5%, 10%). The webinar discussion suggests it likely needs to be meaningfully higher than 1%—perhaps in the 5–10%+ range—before CMS seriously considers permanent, reimbursed Category 1 digital pathology codes.
A: NovoPath:
- Integrates with major digital slide viewers to detect digitally read cases.
- Automatically applies corresponding digital add-on CPT codes based on the base pathology CPT.
- Sends structured data to RCM systems, reducing manual coding and billing work.
- Acts as a consultative partner, helping labs design digital workflows, understand regulations, and scale reporting.
A: Yes. Labs already see value from:
- AI-assisted workflows that increase productivity and case throughput
- Remote reading flexibility for pathologists (work-from-home days)
- Competitive differentiation in their market and better recruitment/retention of pathologists
