ASCP Urges CMS to Restore Remote Review Authority for Digital Cytology Images

March 09, 2026

  • In a recent meeting with CMS, ASCP urged the agency to reconsider its position that CLIA prohibits pathologists from remotely reviewing digital cytology images 

  • CMS maintains that CLIA does not allow remote review of cytology images; ASCP disagrees and is seeking legal reconsideration from the agency 

On February 13, 2026, ASCP met with Center for Medicare & Medicaid Services (CMS), urging the agency to restore the ability of pathologists to remotely review digital cytology images.  

CMS had amended its policy on September 23, 2025, on what services could be provided remotely. The agency’s policy, outlined in memo QSO-23-15-CLIA REVISED, rescinds the ability of pathologists and cytologists to remotely review “digital images of cytology slides” (digital cytology images). CMS maintains that the CLIA statute requires all cytology screening to be performed in the laboratory.   

ASCP acknowledges that that the CLIA statute does state that screening must take place in the laboratory—thus preventing cytologists from performing screening of digital cytology images remotely—but it does not require interpretations to be performed within the laboratory. As part of the meeting, ASCP leaders outlined this point and clarified the differences between preliminary screening, rescreening, and interpretation. In response, the Agency urged ASCP to submit a formal request asking the Agency to revisit its position on the CLIA statute. ASCP submitted that letter to the Agency on February 19, 2026, outlining the reasons we believe the CLIA statute does not require pathologists to provide interpretations within a laboratory setting and asking the Agency to revise its memo accordingly.  

It is unclear when CMS may rule on ASCP’s request; however, we anticipate a response could take several months at least. In the meantime, CMS’s new policy on remote review will be going into effect on March 23, 2026, meaning the remote review of digital cytology images will not be allowed under the Memo after that date (individuals may, however, seek a separate CLIA certificate to review digital images at a remote location).  

For further details in the interim, please review CMS’s revised memo (See here). 

 

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