Jordan Johnson, Founding Partner at Bridge Oncology, shared on LinkedIn:
“CMS dropped the 2027 Final Rule last week.
Less than 8 hours later, Bridge Oncology subscribers had the breakdown in their inbox. Not a headline recap. A read on what it actually means for oncology practices.
Here’s some of what was in it:
- 340B goes to ASP minus 28%. CMS backed off its proposed −33.4% but still finalized a big cut from today’s ASP + 6%. Litigation looks likely, and 340B hospitals should be modeling the impact now.
- The hospital 77412 premium is gone. CMS moved 77407 into the same APC as 77412, so both now pay $535.88 in the HOPD. That $170.46 per-fraction gap a lot of SGRT ROI models were built on? Zero. This wasn’t in the proposed rule.
- Freestanding went the other way. Under the MPFS, the 77412 vs. 77407 gap actually widens to $133.45 per fraction. Same patient, same treatment, two very different financial stakes depending on where the linac sits.
- Why equal pay doesn’t fix the problem. Two codes still means two definitions, and payers will keep using that line for prior auth and denials. We walked through the worst case: a breast patient approved for 77407 who needs DIBH mid-planning.
- Plus national pricing for proton, new RPM/RTM rules, G2211 becoming the B1 modifier, the new 20% Modifier 25 reduction, and a 2.3% conversion factor cut.
That’s what a Bridge Oncology Newsletter looks like. When big news breaks, we move fast. The rest of the time, you’ll find us in your inbox every Monday at 9am. Subscribe here for more.”
You can also read an interesting articles from Jordan Johnson on OncoDaily:
Jordan Johnson Examines Medicare’s 2027 Final Rule and Its Implications for Radiation Oncology