ASTRO expects massive changes to radiation oncology when the Centers for Medicare and Medicaid Services (CMS) release the 2026 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS) proposed rules in coming weeks. Typically, the proposals are released around July 4, with the final rules being released in early November.

This year’s rules are expected to contain many items of great importance to radiation oncology, including the expected introduction of new radiation treatment delivery and image guidance coding, changes to superficial radiation therapy coding, the respective valuation of these codes, as well as more information about how the Agency will be handling the revaluation of practice expense across all medical specialties. Practice expense or “PE” represents 75% of the value of an average radiation oncology CPT code, so how CMS decides to update this component of reimbursement has a large impact on the specialty.

ASTRO has been preparing for these significant changes for years, including the introduction of the ROCR Act and a recent survey showing the impact of further Medicare payment cuts on the specialty. To help the specialty prepare, ASTRO and ACRO health policy physician leaders previewed these changes in a ASTROblog post earlier this year, as well as discussion during the March 13 Town Hall. Check out What’s Happening in Washington for more on the ramifications of changes to PE.