As of March 1, 2026, Clinical Laboratory Improvement Amendments (CLIA) fees and certificates are fully electronic, according to the Centers for Medicare & Medicaid Services (CMS).

CMS has issued a reminder to laboratories to sign up for email notifications now. They emphasized that all fees must be paid online starting March 1^st, and “failure to go paperless may result in billing or certification issues.” CMS noted that “This doesn’t apply to CLIA-exempt states or state licensure.”

Labs can update their email with their state agencies or their accreditation organization. Detailed instructions can be found in this toolkit and fact sheet.

CMS has more information

This page is updated as of March 4, 2026.