The Medicare Payment Advisory Commission (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997 to advise Congress on issues affecting the Medicare Program. MedPAC meets publicly to discuss policy issues and formulate its recommendations via two annual reports to the Congress.

Recently, MedPAC has expressed concern regarding the limited payment updates to the Medicare Physician Fee Schedule (MPFS) conversion factor. The Commission believes that continued flat or reduced payment for physician services will result in access to care issues for Medicare beneficiaries. As a result, the Commission has formulated the following policy recommendations for inclusion in its March 2025 report to Congress:

• Replace current law updates to MPFS rates with a single update equal to the projected increase in Medicare Economic Index (MEI) minus 1%.
• Enact safety net add-on payments under the MPFS for services delivered to low-income Medicare beneficiaries. MedPAC recommends a 15% add on payment for primary care physicians and a 5% add on payment for specialty care.

While Congress relies on MedPAC for guidance, it is not compelled to implement the Commission’s recommendations. ASTRO will continue to monitor MedPAC discussions on this and other topics related to radiation oncology payment.