Brian Lally, President of American College of Radiation Oncology, shared a post on LinkedIn:
“Why the 2027 HOPPS Proposed Rule is a Major Win for Clinical Stability in Radiation Oncology
Deciphering federal updates usually requires a team of lawyers, but the 2027 HOPPS proposed rule delivers a clear, data-driven win for the #RadOnc community. As highlighted in my latest video segment, CMS is actively working to protect clinical access and ensure predictable billing structures.
Two critical takeaways stand out:
- Substantial Hikes in Daily Treatment Delivery Lines The redistribution map is channeling real support into non-onc APC codes, resulting in substantial double-digit rate hikes across the board:
5621 is jumping by 26%
5622 is up by 17%
5623 is up by 14% - Policy Flexibility & The “Two-Times Rule” Exception Data screening showed that our standard clinical planning and preparation sequences (5611, 5612, and 5613) crossed the statutory two-times rule cost threshold. Normally, this triggers an automatic, rigid restructuring of the codes. However, recognizing the unique, complex nature of radiation oncology planning, CMS has proactively granted an official exception policy for 2027—freezing the existing payment structure.
It is incredibly refreshing to see a federal agency prioritize clinical stability and predictable billing over pure mathematical automation. How is your department adjusting its 2027 pro forma projections based on these updates? Let’s discuss in the comments.”
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