Medicare Announces Lower-Than-Feared Cuts to Radiation Oncology Fees

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(ChemotherapyAdvisor) –  The US Centers for Medicare and Medicaid Services (CMS) has announced a final decision about cuts to Medicare reimbursements for radiation oncology services, representing fee reductions that will be much less drastic than the agency had initially proposed earlier this year.

The changes reflect an overall 9% cut in Medicare payments to radiation therapy centers and 7% cut in Medicare payments for radiation oncology services overall, said Michael L. Steinberg, MD, FASTRO, chairman of the American Society for Radiation Oncology's (ASTRO)'s Board of Directors. That's much less draconian than the originally-proposed cuts of up to 40% for these services, he noted.

The new 2013 Medicare Physician Fee Schedule (MPFS) will take effect on January 1, 2013.

“Nearly 65% of all cancer patients receive radiation treatment as part of their care,” Dr. Steinberg said. “While we remain concerned about the overall level of the cuts to radiation oncology, we appreciate that CMS heard our concerns, and we look forward to working with CMS and Congress to achieve meaningful payment reforms that place incentives on value rather than volume.”

ASTRO officials had expressed dismay at the magnitude of the originally-proposed cuts to radiotherapy services. The original proposal would have cut assumed radiotherapy delivery times from 60 minutes to 30 minutes for intensity-modulated radiotherapy (IMRT) and from 90 minutes to 60 minutes for stereotactic body radiotherapy (SBRT); that would have slashed reimbursements by 40% for IMRT and 28% for SBRT, Dr. Steinberg had warned.

But SBRT often requires “complex” planning involving hours of patients on the table, Steinberg had warned. The new fee structures will better accommodate complex radiotherapy plans. CMS also “positively responded” to ASTRO's recommendation that reimbursements also accommodate a second radiation therapist's involvement in IMRT delivery, said ASTRO spokeswoman Michelle Kirkwood.

Lobbying by ASTRO and other professional organizations led to letters of bipartisan opposition to the proposed Medicare cuts to radiotherapy fees, signed by 130 members of the US Congress from 43 states, Kirkwood said.

ASTRO website

CMS website

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