Radiation oncologists are experiencing negative financial effects from federal reimbursement changes that took effect Jan. 1, according to survey data published April 1 by the American Society for Radiation Oncology.
At the start of 2026, CMS’ Medicare Physician Fee Schedule and Hospital Outpatient Payment System consolidated all radiation oncology treatment codes into three levels of complexity regardless of whether care was delivered in a hospital or freestanding facility setting.
“Federal officials estimated the changes would reduce payments by about 1% for the specialty overall, but more than two-thirds of physicians surveyed reported declines of 10% or greater,” the ASTRO said in an April 1 news release.
The organization surveyed 160 U.S.-based radiation oncologists in March to assess any initial effects from the coding changes. Here are four things to know from the survey:
- The following share of survey respondents said they were experiencing significant impact from the new radiation treatment delivery codes in these areas:
- Practice impact, facility: 76%
- Practice impact, nonfacility: 68%
- Personal payroll impact: 50%
- Personal bonus impact: 50%
- Radiation oncologists practicing at freestanding centers are experiencing downcoding and denials more frequently than those in the hospital setting.
- The following share of level 3 cases — representing the highest complexity of treatment delivery technique — are being downcoded or denied by payers, even after appeals:
- Freestanding facilities: 65%
- Hospitals: 36%
- Survey respondents said the reasons for level 3 treatment delivery challenges were:
- Payer interpretation of code definitions: 92%
- Documentation requirements: 39%
- Billing or vendor guidance: 28%
- Internal coding uncertainty: 26%
Read the full survey results here.
At the Becker's Perioperative Summit, taking place September 14–15 in Chicago, perioperative leaders and healthcare executives will focus on improving operating room efficiency, enhancing patient safety, optimizing staffing and driving innovation across surgical services. Apply for complimentary registration now.
