Compensation for radiologists and radiation oncologists, among other specialties, will become tighter in the new year under the Centers for Medicare & Medicaid Services’ 2024 Medicare Physician Fee Schedule (PFS) final rule, which has medical groups on behalf of both specialties and others fired up.

Under the final rule, payment amounts will decrease by 1.25% overall compared to the calendar year 2023. In radiology and nuclear medicine, clinicians will see 3% cuts, while interventional radiologists will see 4% cuts.

“MITA is extremely concerned that the proposed rule’s payment cuts would undermine physicians’ ability to continue to provide high-quality imaging services to patients,” said Patrick Hope, executive director of the Medical Imaging & Technology Alliance, in a statement.
According to Dr. Jeff Michalski, FASTRO, chair of the ASTRO board of directors, cuts for radiation oncology will be 2%, which, combined with past cuts, marks a 25% decrease in physician payments between 2013 to 2024; more than nearly all other medical specialties.

“The time has come for Congress to intervene with reform legislation to ensure short-term stability and long-term viability,” he said.

Already, the U.S. Senate Committee on Finance has passed legislation, the Better Mental Health Care, Lower Drug Cost, and Extenders Act, to reduce the cuts by extending essential Medicaid and Medicare provisions that will expire this year to protect safety-net hospitals, rural providers, and patients.

According to CMS, the cuts are necessary as part of its budget neutrality approach for supporting increases in payments for primary care and mental health, along with health equity and certain oral health, and align with President Joe Biden’s Cancer Moonshot plan.

Dr. Meena Seshamani, CMS deputy administrator and director of the Center for Medicare, said these measures will facilitate access to different types of “counselors for behavioral health treatment” and “primary care” where the provider is invested in a "long-term, trusting relationship” as well as culturally-sensitive care and appropriate training for caregivers of Medicare patients.

In a letter sent by MITA in September to CMS, the association said the cuts would exacerbate the financial strain of the COVID-19 pandemic, and requested that CMS reduce the impact or delay implementation and work with Congress on policies that ensure the ongoing stability of the PFS.

Earlier this year, ASTRO introduced the Radiation Oncology Case Rate (ROCR) legislative proposal, which called for the creation of a new Medicare payment system for radiation oncology based on the value of the care provided, rather than the volume of services, to stabilize payments. It said it would reduce health disparities, lower costs for both patients and Medicare and improve quality of care.

Additionally, Stacey Hughes, executive vice president of the American Hospital Association, called the 3.1% increases under the rule for outpatient hospitals “inadequate,” saying that it is not enough to address the financial challenges they face.

“Hospitals’ and health systems’ ability to continue caring for patients and providing essential services for their communities may be in jeopardy, which is why the AHA is urging Congress for additional support by the end of the year,” she said.

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