The American Society for Radiation Oncology (ASTRO) has called on the U.S. Centers for Medicare & Medicaid Services (CMS) to take stronger action on radiation oncology reimbursement.
In a statement accompanying formal comments submitted September 10 on the proposed 2027 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS), ASTRO Board of Directors Chair Sameer Keole, MD, noted that radiation oncology practices entered 2026 under significant financial pressure, and the experience on the ground has been far worse than federal estimates suggested.
“CMS projected that coding and payment changes implemented January 1 would reduce radiation oncology reimbursement by 1% overall, yet more than two-thirds of radiation oncologists responding to an ASTRO survey this spring reported declines of 10% or more, with many reporting cuts of 20% to 30%,” Keole said.
That survey further found that respondents reported being forced to lay off staff -- including physicians -- and implement hiring freezes, ASTRO noted.
The instability is especially troubling when access to radiation therapy is already fragile, the society added, with recent research showing that more than 50 million Americans live in counties without a radiation oncology practice.
“Rural and freestanding treatment centers are particularly vulnerable to disappearing. Patients shouldn’t lose access to cancer treatment because Medicare reimbursement fails to reflect what it costs to provide modern radiation therapy,” Keole said.
The society and nearly 140 stakeholder organizations support the bipartisan Radiation Oncology Case Rate (ROCR) Act, which the society says offers a value-based long-term fix for radiation oncology reimbursement. ROCR is co-sponsored by more than 50 members of Congress across both chambers.
