July 12, 2024

Arlington, Va.—The Medical Imaging & Technology Alliance (MITA), a division of the National Electrical Manufacturers Association (NEMA), applauds the Centers for Medicare & Medicaid Services’ (CMS) proposed Medicare payment changes for diagnostic radiopharmaceuticals in its Hospital Outpatient Prospective Payment System (OPPS) rule.

In the proposed 2025 OPPS rule, diagnostic radiopharmaceuticals with a per-day cost above $630 would now be paid separately by CMS for traditional Medicare-Fee-for-Service patients in OPPS after pass-through payment status ends.

“This proposed change recognizes these vitally important FDA-approved drugs as drugs under the Medicare Hospital Outpatient Setting,” said Sue Bunning, MITA’s Managing Director of Positron Emission Tomography. “Access to diagnostic radiopharmaceuticals is essential to providing patients with accurate diagnoses and access to a number of therapies, so CMS’ proposed change will make a major difference for many patients. With positron emission tomography (PET), you cannot get the diagnosis without the drug.”

MITA is the leading organization and collective voice of radiopharmaceutical manufacturers, innovators, and product developers. MITA appreciates the more than 125 organizations of patients, physicians, hospitals, drug innovators and manufacturers who support separate payment for diagnostic radiopharmaceuticals. We also appreciate the members of Congress who have worked this year to advance the Facilitating Innovative Nuclear Diagnostics (FIND) Act. We look forward to CMS finalizing this vital change in the final 2025 OPPS rule.