CMS has issued a new add-on payment for radiopharmaceuticals that use domestically produced radioisotopes, starting Jan. 1, 2026, as part of its 2025 Hospital Outpatient Prospective Payment System rule shared Nov. 1.
Here are four things to know about the payment:
- Radioisotopes, specifically Mo-99 and Tc-99m, are crucial for the detection of disease in medical imaging and radiopharmaceuticals. Tc‑99m and its source material, Mo-99, are historically derived from reactors outside the U.S.
- A $10-per-dose add-on payment for radiopharmaceuticals that use Tc-99m derived from domestically produced Mo-99 will begin Jan. 1, 2026.
- CMS said paying providers that use domestically produced Tc-99m radiopharmaceuticals will offset anticipated higher costs.
- "These artificially low, foreign government-subsidized prices have created a disincentive for domestic investments in Mo-99 production infrastructure and a barrier to entry for new producers," CMS said in a Nov. 1 news release.