ASTRO calls for stronger response to ongoing radiation oncology payment pressures in comments to CMS

The American Society for Radiation Oncology (ASTRO) issued the following statement today from Sameer Keole, MD, FASTRO, Chair of the ASTRO Board of Directors, accompanying formal comments submitted to the Centers for Medicare & Medicaid Services (CMS) in response to the proposed 2027 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS):

“Radiation oncology practices entered 2026 under significant financial pressure, and the experience on the ground has been far worse than federal estimates suggested. CMS projected that coding and payment changes implemented January 1 would reduce radiation oncology reimbursement by 1% overall, yet more than two-thirds of radiation oncologists responding to an ASTRO survey this spring reported declines of 10% or more, with many reporting cuts of 20% to 30%.

That instability is especially troubling when access to radiation therapy is already fragile. More than 50 million Americans live in counties without a radiation oncology practice, and recent research shows rural and freestanding treatment centers are particularly vulnerable to disappearing. Patients shouldn’t lose access to cancer treatment because Medicare reimbursement fails to reflect what it costs to provide modern radiation therapy.

We appreciate that the proposed 2027 rules include some constructive steps, including continued use of hospital data to inform freestanding payments and increases to certain key services. But the specialty is digging out of a deep financial hole and important problems remain. ASTRO is urging CMS to correct a hospital payment assignment that continues to undervalue a commonly delivered service, severely impacting independent, freestanding centers. We also are asking CMS to take a more deliberate approach to major payment methodology changes when the data and potential effects on patient access are not yet clear.

Looking forward, annual regulatory fixes cannot solve a payment system constrained by budget neutrality and misaligned with high-quality care. That’s why we continue to call on Congress to provide the long-term stability patients and practices need by passing the bipartisan Radiation Oncology Case Rate Act.”

ASTRO and nearly 140 stakeholder organizations support the bipartisan Radiation Oncology Case Rate (ROCR) Act, which offers a value-based fix for radiation oncology reimbursement. ROCR is co-sponsored by more than 50 bipartisan members of Congress across both chambers. For more information about ROCR and radiation oncology payment reform, view our press kit.

ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the world’s largest professional society dedicated to advancing radiation medicine, with 11,000 members including physicians, nurses, physicists, radiation therapists, dosimetrists and other professionals who work to improve patient outcomes through clinical care, research, education and advocacy. Radiation therapy is integral to 40% of cancer cures worldwide, and more than one million Americans receive radiation treatments for their cancer each year. For information on radiation therapy, visit Speed of Light - The ASTRO Foundation. To learn more about ASTRO, visit our website and press room and connect with us on social media.