ACRO Statement on 2026 Physician Fee Schedule Final Rule

The following is a message from the American College of Radiation Oncology's Government Relations & Economics Committee (GREC):

Yesterday, the 2026 Physician Fee Schedule (PFS) Final Rule was published in the Federal Register. Due to errors contained in certain addenda in the 2026 PFS Final Rule pre-publication last Friday, ACRO is issuing the following statement notwithstanding that we still await the publication of the 2026 Hospital Outpatient PPS (HOPPS) Final Rule.

Importantly, we do know from the 2026 PFS Final Rule that CMS believes “the use of OPPS APC relative weights to establish the relative relationship of PE RVUs for radiation treatment delivery services is more suited for capital-intensive services.” However, in the 2026 HOPPS Proposed Rule, CMS placed the new treatment delivery codes (77402, 77407, and 77412) into inappropriately low ambulatory payment classifications (APCs), which carried over to the 2026 PFS Proposed Rule rates for these same treatment delivery codes in the freestanding setting.

ACRO advocated for a correction in the 2026 HOPPS Final Rule and, while the HOPPS Final Rule has not been published, it appears by inference that a correction did occur based on the rates in the 2026 PFS Final Rule. ACRO estimates that this correction results in an smaller cut in 2026 rates for radiation treatment delivery services in comparison to 2025 from -10% in the 2026 PFS Proposed Rule to -3.8% in the 2026 PFS Final Rule. Separately, the Indirect Practice Expense (IPE) policy in the 2026 PFS Final Rule increases rates for non-treatment delivery codes by 5.2%, which offsets these reductions in the treatment delivery codes.

In addition, the efficiency adjustment policy (2.5% decrease in work RVUs) also is maintained in the 2026 PFS Final Rule. ACRO will work with other stakeholders to advocate for changes to the efficiency adjustment during upcoming healthcare legislative deliberations in the Congress.

ACRO continues to support radiation oncology case rate legislation as part of a broader effort to remove high-cost equipment and supplies from the Medicare Physician Fee Schedule. The College appreciates CMS’ acknowledgement that the PFS does not properly value medical supplies and equipment and reiterates that the Physician Fee Schedule was not built for high-cost supplies and equipment. ACRO urges Congress to work with CMS to enact legislation to provide permanent stability to providers of radiation oncology services.

ACRO will provide further information on the new treatment delivery codes in the weeks ahead.