Medicare changes course on proposed payment cuts to radiation therapy in 2015 Medicare Physician Fee Schedule
The American Society for Radiation Oncology (ASTRO) today applauds the Centers for Medicare and Medicaid Services (CMS) for not implementing proposed payment cuts for radiation therapy starting January 1, 2015, as detailed in the final 2015 Medicare Physician Fee Schedule (MPFS), issued on Friday, October 31, 2014. ASTRO also thanks radiation oncology’s congressional champions for working with CMS to protect cancer patients’ access to radiation therapy across the country.
The 2015 MPFS estimates that radiation oncologists will see no change in total allowed charges beginning January 1, 2015. The MPFS sets 2015 Medicare payment rates and policies for global payments (professional and technical) performed in the freestanding environment and professional payments for services performed in the hospital outpatient environment.
The 2015 MPFS final rule states that CMS will delay its decision for one year regarding classification of the radiation treatment vault because the issue needs detailed study and evaluation. In addition, CMS has delayed implementation of new radiation treatment delivery codes until 2016. For 2015, CMS will continue to use 2014 price inputs, however, reimbursement rates may change. Since some 2014 treatment codes were deleted, CMS will create G-codes as necessary to allow for reporting these services in 2015. The agency said it will pay for the G-codes the same way it did for the predecessor codes in 2014.
“ASTRO greatly appreciates federal policymakers’ attention to the importance of preserving patients’ access to radiation oncology services,” said Bruce G. Haffty, MD, FASTRO, chair of ASTRO’s Board of Directors. “As CMS reconsiders these issues next year, we look forward to working with the agency and Congress to end the instability in reimbursement for community-based radiation therapy centers so we can ensure that patients and their treatment team can focus on what’s most important: curing their cancer. We are extremely grateful to several congressional leaders, particularly Sens. Stabenow and Burr, as well as Reps. Pitts, Pallone, Nunes, Tonko, for their commitment and tireless work to support radiation oncology and the life-saving care we provide to more than one million cancer patients.”
On July 3, 2014, Medicare proposed rates for the 2015 physician fee schedule that would have cut radiation oncology payments by 4 percent and community-based radiation therapy centers by 6 to 8 percent. The proposal most significantly impacting radiation oncology would have removed the radiation treatment vault as a direct practice expense input from radiation treatment procedure codes. ASTRO expressed serious concerns in July about the proposed cuts and their potential negative impact on patient access to radiation therapy. More than 160 bipartisan Senators and Representatives, led by Sens. Debbie Stabenow (D-Mich.) and Richard Burr (R-N.C.), as well as Reps. Joe Pitts (R-Penn.), Frank Pallone (D-N.J.), Devin Nunes (R-Calif.) and Gary Tonko (D-N.Y.), agreed with ASTRO and sent several letters in September 2014 to CMS expressing serious concerns about the proposed Medicare payment cuts.
ASTRO is the premier radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals that specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes two medical journals, International Journal of Radiation Oncology•Biology•Physics (www.redjournal.org) and Practical Radiation Oncology (www.practicalradonc.org); developed and maintains an extensive patient website, www.rtanswers.org; and created the Radiation Oncology Institute (www.roinstitute.org), a non-profit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visitwww.astro.org.