Payers fail to reset radiation oncology payments, risking clinic closures

Major payers have not updated their radiation oncology fee schedules to align with significant 2026 CPT and HCPCS code changes, creating unsustainable reimbursement shortfalls for oncology clinics. A leading oncologist warns this payment gap may force some independent clinics to close. The coding overhaul shifted billing for complex treatments like stereotactic body radiation therapy (SBRT) and intensity-modulated radiation therapy (IMRT), but payer systems are still applying outdated rates. This creates a 15-30% reimbursement cut on high-cost services, eroding margins. Oncology practices must immediately audit their payer contracts and recent remittance advices for these services. Contact your payer representatives to demand fee schedule updates and consider filing corrected claims if you billed under the new codes but were paid at old rates. Escalate through provider dispute resolution if payers refuse to align.