Radiation oncology physician payments to continue tumble, but Medicare proposes no new cuts
July 10, 2024
Today, the Centers for Medicare and Medicaid Services (CMS) proposed no additional direct payment cuts to radiation therapy physician services, but existing policies will continue to depress payments next year. CMS also is poised to agree with ASTRO that radiation weekly treatment management should not be eligible for telehealth, while the Agency plans to maintain supervision flexibilities as part of its rulemaking plan for 2025.
The Medicare Physician Fee Schedule (MPFS) proposal includes the expected final year of cuts to radiation therapy due to the recent update to clinical labor pricing, but no new cuts. In aggregate, the Agency estimates flat payments for radiation oncology in 2025, but the clinical labor cuts and 2.8% proposed conversion factor reduction will cause many key codes to drop. ASTRO remains very concerned by the 23% decline in radiation oncology payments since 2011 and significant payment threats in future years, and we urge Congress to pass the bipartisan Radiation Oncology Case Rate (ROCR) Act to secure long-term stable payments and enhanced quality.
In the Hospital Outpatient Prospective Payment System (HOPPS) rule, the Agency is proposing modest payment increases for radiation therapy services in 2025. CMS also proposes to extend the availability of virtual direct supervision of therapeutic and diagnostic services through December 31, 2025.
ASTRO will provide members with a summary and detailed analysis of the proposals in the coming days and will submit comments to the Agency later this summer.
The Medicare Physician Fee Schedule (MPFS) proposal includes the expected final year of cuts to radiation therapy due to the recent update to clinical labor pricing, but no new cuts. In aggregate, the Agency estimates flat payments for radiation oncology in 2025, but the clinical labor cuts and 2.8% proposed conversion factor reduction will cause many key codes to drop. ASTRO remains very concerned by the 23% decline in radiation oncology payments since 2011 and significant payment threats in future years, and we urge Congress to pass the bipartisan Radiation Oncology Case Rate (ROCR) Act to secure long-term stable payments and enhanced quality.
In the Hospital Outpatient Prospective Payment System (HOPPS) rule, the Agency is proposing modest payment increases for radiation therapy services in 2025. CMS also proposes to extend the availability of virtual direct supervision of therapeutic and diagnostic services through December 31, 2025.
ASTRO will provide members with a summary and detailed analysis of the proposals in the coming days and will submit comments to the Agency later this summer.
