Radiation Therapy Freeze Extended  – update 11-1-19

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On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) released the CY 2020 Physician Fee Schedule Proposed Rule.  In the rule, CMS states the following:

Following the publication of the CY 2015 PFS final rule, the Patient Access and Medicare Protection Act (Pub. L. 114-115, December 28, 2015) was enacted, which included the provision that the code definitions, the work relative value units and the direct inputs for the PE RVUs for radiation treatment delivery and related imaging services (identified in 2016 by HCPCS G-codes G6001 through G6015) for the fee schedule established under this subsection for services furnished in 2017 and 2018 shall be the same as such definitions, units, and inputs for such services for the fee schedule established for services furnished in 2016. In CY 2018, Congress extended this “freeze” in coding descriptions and inputs through CY 2019 as a provision of the Bipartisan Budget Act of 2018. For CY 2020, in the interest of payment stability, we are proposing to continue using these G-codes, as well as their current work RVUs and direct PE inputs.

In our comments to the Proposed Rule, ACRO supported the CMS proposal to continue the radiation therapy freeze.

Today, CMS released the CY 2020 Physician Fee Schedule Final Rule with the following language:

After consideration of the public comments, we are finalizing our proposal to continue making payment for these services using HCPCS G-codes G6001 through G6017 with their current work RVUs and direct PE inputs.

We are grateful that CMS has listened to ACRO’s concerns regarding payment stability in the Physician Fee Schedule and continued the freeze on radiation therapy services in the Final Rule.

To review the regulation, please click on this link.

For any questions about this announcement, please contact
Jason McKitrick, ACRO government relations staff: jmckitrick@libertypartnersgroup.com