ACRO Board Endorses Op-Ed: The Physician Fee Schedule Was Not Built for High Cost Supplies and Equip

The Board of Chancellors for the American College of Radiation Oncology has endorsed the Op-Ed "The Physician Fee Schedule Was Not Built for High-Cost Supplies and Equipment," authored by ACRO members Dr. Tarita Thomas, Dr. Amulya Yalamanchili, and Jason McKitrick, and colleagues Drs. David Rasmussen, Bob Tahara, and Gerald Niedzwiecki, which is now published on CURiE.

The PFS has not kept pace with the advances in technology that allow for minimally invasive procedures to be performed in the office setting. These technological advances are beneficial to patients yet are becoming increasingly challenging to access as physicians cannot keep office-based practices open. Physicians cannot be paid less than their practice expenses but this has been happening consistently for decades.

Budget neutrality, a critical concept in the PFS has led to nearly two decades of reduction in the valuation of office-based interventional services utilizing high-cost supplies and equipment. These cuts have been so severe that in 2024 for procedures CMS reimburses in the office, 195 are paid at rates actually less than the direct costs associated with those procedures as calculated by CMS itself. In 2025 this number will grow to over 300 services.

The main source of reimbursement cuts for office-based interventionalists including radiation oncology is not from the conversion factor but relates to practice expense.

Importantly Medicare reimbursement for interventional services in the hospital setting is made through a different fee schedule than the PFS – rather through HOPPS – which continues to increase as office based reimbursement continues to fall.

In order to serve our patients most efficiently with advances in technology in the office setting high cost supplies and equipment need to be removed from the PFS.

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