CMS finalizes radioisotope add-on payment

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. 

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Here are four things to know about the payment:

  1. 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.
  2. A $10-per-dose add-on payment for radiopharmaceuticals that use Tc-99m derived from domestically produced Mo-99 will begin Jan. 1, 2026.
  3. CMS said paying providers that use domestically produced Tc-99m radiopharmaceuticals will offset anticipated higher costs.
  4. “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.

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