PAMA lets CMS cut Clinical Laboratory Fee Schedule rates by up to 15% a year across 2027, 2028 and 2029. Meridian is a deterministic model of that cliff: enter your real test mix and it compounds the statutory cuts, year by year, and shows exactly how much revenue is at risk — entirely in the browser, with no PHI and no clinical data.
Meridian is not an LLM — it's a deterministic financial model. It applies the statute the way CMS will, so the number it hands a lab CFO is one they can plan against.
Takes your annual test mix — CPT/HCPCS codes, 2025 CLFS rates and volumes — and applies the compounding statutory cuts across 2027, 2028 and 2029. Each year's cut lands on the prior year's already-reduced rate, exactly as PAMA compounds it, and the model surfaces the cumulative revenue at risk and your 2029 run-rate versus today.
Checks a lab's exposure to the PAMA private-payor data-reporting requirement — the obligation that sets those rates in the first place — and the $10,000-per-day civil monetary penalty ceiling for failing to report or misreporting. It flags reporting-window exposure so the compliance risk is on the same page as the revenue risk.
Everything runs client-side on public rate data and the numbers you type. No patient data, no upload, no server round-trip — so a lab can model a worst-case cliff in a sales or budgeting meeting without any compliance overhead. It is a planning tool, never a substitute for the CMS-published fee schedule.
Rates and volumes are pre-filled with 2025 CLFS figures for five common lab codes. Edit any cell, drag the cut slider, and watch the revenue at risk compound in real time.
| CPT / HCPCS | 2025 rate ($) | Volume / yr |
|---|
No forecast magic. Meridian applies a public statute to public rates and the mix you enter — so the same inputs always give the same answer.
The seed rates are 2025 Clinical Laboratory Fee Schedule national limits for the listed codes — 80307, G0483, 82306, 81225, 82607. They are published by CMS and are illustrative defaults; you replace them with your own fee schedule.
The Protecting Access to Medicare Act caps CLFS reductions at 15% per year for 2027, 2028 and 2029. Meridian compounds them — 2028's cut applies to 2027's reduced rate, and so on — because that is how the reduction actually stacks. Nothing here is a prediction of what CMS will set; it models the ceiling the statute allows.
Meridian is a planning model, not the CMS fee schedule and not financial advice. The seed rates are illustrative 2025 CLFS figures; the real cuts, statutory floors, and code-level exceptions are set by CMS and can differ from the flat ceiling modelled here.
Ardia is pre-revenue. This tool claims no client results — it exists so a lab can frame its own PAMA exposure on its own numbers, then validate against its specific fee schedule. It handles no PHI and sends nothing to a server.
A deterministic, in-browser model that compounds PAMA's scheduled 2027–2029 CLFS cuts across a lab's own test mix to show cumulative revenue at risk, plus data-reporting and penalty exposure — unit-tested, no PHI, not the CMS fee schedule.
Computes the compounding cliff as the statute stacks it: each year's cut of up to 15% — the reduction cap in SSA §1834A(b)(3) — lands on the prior year's reduced rate across the scheduled 2027–2029 window. Deterministic JavaScript mirrored by a Python engine, covered by 7 unit tests — every figure traces to your inputs, not a black-box forecast.
Takes a lab's annual test mix — CPT and HCPCS Level II codes, 2025 CLFS national payment amounts and volumes — in an editable table seeded with five real lab codes (80307, G0483, 82306, 81225, 82607). Multiplies rate × volume per code and recomputes cumulative revenue at risk and the 2029 run-rate in real time as any cell or the cut slider changes.
Puts compliance risk beside revenue risk: flags exposure to the PAMA private-payor data-reporting obligation (42 CFR Part 414, Subpart G) that determines these rates, and the $10,000-per-day civil monetary penalty ceiling (Social Security Act §1834A(a)(9)) for failing to report or misreporting — so reporting-window exposure sits alongside the dollar impact.
Runs 100% client-side: the test mix never leaves the browser — no PHI, no server round-trip. No LLM is involved; Meridian is a deterministic engine, so results are reproducible and explainable. Seed rates are illustrative defaults from the public CMS 2025 CLFS that you replace with your own fee schedule.
Deterministic PAMA/CLFS engine — compounds the statutory (up to 15%/yr) 2027–2029 cuts over a lab's test mix; 7 unit tests, no LLM, no PHI.
Ship the deterministic in-browser CLFS engine: compounding 2027–2029 cuts, revenue-at-risk and 2029 run-rate over the seeded codes, plus the $10k/day penalty flag. Grow coverage past the current 7 tests.
A design-partner lab loads its own CMS fee schedule and real test-mix volumes under a data agreement (BAA only if PHI enters scope); its finance team validates outputs. Add FHIR / flat-file billing ingest.
Layer in code-level CMS exceptions, statutory floors, and MolDX / Palmetto GBA coverage overlays; refresh CLFS payment amounts on each annual update so the model tracks the published fee schedule, not just the ceiling.
Connect revenue-at-risk to the MolecuIQ denial-recovery workflow (a modelled-target module) so a lab sees rate-cliff exposure and recoverable denials in one reimbursement view.
Meridian is the reimbursement layer for independent labs — alongside MolecuIQ's denial recovery. Explore the full model lineup or talk with the team.