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Total Medicare Part B Spending on Lab Tests Rose in 2024, Driven by Increased Spending on Genetic Tests

Issued on  | Posted on  | Report number: OEI-09-25-00330

Report Materials

Key Takeaways

  • In 2024, Medicare Part B spending on clinical diagnostic laboratory tests (lab tests) totaled $8.4 billion—a 5-percent increase over the previous year. Spending on lab tests is climbing even as the number of Part B enrollees with lab tests is decreasing.
  • Part B spending on lab tests has been shifting increasingly toward genetic tests, including tests related to cancer, infections, and epilepsy. In 2024, genetic tests accounted for 43 percent of all Part B lab spending, with expenditures topping $3.6 billion.
  • Overall, Medicare Part B spending for non-genetic tests, including metabolic panels, lipid panels, and complete blood cell counts, has been generally declining since 2021, dropping to $4.8 billion in 2024.
  • In 2024, the top 25 lab tests accounted for almost half of all Part B lab spending, with expenditures exceeding $4.1 billion. The test with the highest expenditures was a genetic test with a median payment amount of $447 per claim.

Why OIG Did This Review

This review is part of an ongoing effort to control Medicare Part B spending on lab tests. The Protecting Access to Medicare Act of 2014 (PAMA) changed the way Medicare Part B pays for lab tests, effective 2018. To monitor changes to Part B lab test spending, PAMA also mandated that OIG publicly release an annual analysis of the top 25 lab tests and conduct analyses that OIG determines appropriate. This data snapshot provides an analysis of Medicare Part B payments for lab tests in 2024, including an analysis of the 25 tests that cost Part B the most money.

What OIG Did

This review is part of an ongoing effort to control Medicare Part B spending on lab tests. The Protecting Access to Medicare Act of 2014 (PAMA) changed the way Medicare Part B pays for lab tests, effective 2018. To monitor changes to Part B lab test spending, PAMA also mandated that OIG publicly release an annual analysis of the top 25 lab tests and conduct analyses that OIG determines appropriate. This data snapshot provides an analysis of Medicare Part B payments for lab tests in 2024, including an analysis of the 25 tests that cost Part B the most money.

What OIG Recommends

This data snapshot contains no recommendations.

Report Type
Evaluation
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
Laboratories OIG Statutory Authority and Regulatory Matters
Target Groups
–
Financial Groups
Medicare B

Notice

This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.