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CMS is proposing cuts to Radiation Therapy and Oncology by 3-9%
On July 8, 2015 the Centers for Medicare & Medicaid Services (CMS) proposed a rule that updates payment policies, payment rates, and quality provisions for services under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2016. The rule also finalizes changes to the quality reporting initiatives associated with PFS payments, including the Physician Quality Reporting System (PQRS), the Physician Value-Based Payment Modifier (Value Modifier), and the Medicare Electronic Health Record (EHR) Incentive Program, as well as changes to the Physician Compare website on Medicare.gov.
This is the first PFS proposed rule under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which replaced the Sustainable Growth Rate (SGR) formula.
The net result for radiology is:
- 1% boost for interventional radiology
- 3-9% reduction for radiation oncology and radiation therapy
This continues a trend of payment reductions in recent years and is is part of the agency’s efforts to reduce payment for services areas it considers overvalued.
CMS is accepting comments on the proposed CY 2016 PFS rule until September 8, 2015 and CMS will issue the final rule by November 1.