Medicare Payments

Timeline:

• December 2021: Congress passes ASTRO-supported legislation to delay RO Model implementation.

• April 2022: The Centers for Medicare and Medicaid Services (CMS) released proposed rulemaking to indefinitely delay RO Model implementation.

• August 2022: CMS releases final rule that indefinitely delays RO Model implementation.

• November 2022: CMS releases Medicare Physician Fee Schedule (MPFS) final rule that includes a 4% cut to the annual conversion factor, continued cuts due to clinical labor policy.

• December 2022: Congress passes legislation to provide relief from MPFS cuts including:
  • Two years of Medicare physician conversion factor payment cut relief of 2.5% in the first year, and 1.25% the following.
  • 4% PAYGO sequester penalties waived.

What’s next: While these provisions provide some relief, the legislation did not repair the full cut to radiation oncology and set a lower level of relief come 2024. In addition, CMS signaled in the MPFS final rule that it could seek to revalue key radiation treatment delivery and image guidance codes, which could lead to additional cuts in 2024. ASTRO remains committed to fighting for long-term payment reform that will stabilize payments and reward high-quality, high-value care, and we continue to work with Congress to reach that goal.