06/17/2025

WPS Recent Oncology Related News

Recent WPS Articles That May be of Interest to Oncology:

WPS PART A ONLY

Inpatient Hospital Admissions: Transferring Medical Review Responsibilities for Short Stay Claims
Starting September 1, 2025, the Medicare Administrative Contractors will assume responsibility for conducting patient status reviews of facilities to determine the appropriateness of Part A payment for short stay inpatient hospital claims. These reviews were previously conducted by the Beneficiary and Family Centered Care Quality Improvement Organization. While this change affects where medical record requests will be sent and the contractor making claim review decisions, the policy for assessing short stay inpatient admissions remains unchanged.

For more information, visit the Inpatient Hospital Reviews webpage.

WPS PART B ONLY

Medicare Part B 2024 Fee Schedule Loc 1 (file download)
Effective January 1, 2025 

Medicare Part B 2024 Fee Schedule Loc 99 (file download)
Effective January 1, 2025 

PFS National Payment Amount File 

PFS Relative Value Files 

• Physician Fee Schedule – April 2025 release
• ASP Pricing Files 
  • April 2025 ASP Pricing File (file download) 
  • April 2025 NOC Pricing File (file download) 
  • April 2025 ASP NDC-HCPCS Crosswalk (file download) 
• ASC Addenda (file download) 

2025 Ambulatory Surgical Center (ASC) Fee Schedules 

Anesthesia Pricing

• Anesthesia Base Units
• 2025 Anesthesia Conversion Factors

Clinical Psychologist Pricing
The clinical psychologist is available on the Physician Fee Schedule.

Clinical Social Worker Pricing
The clinical social worker fees are available in the Physician Fee Schedule. To determine the fee, multiply the fee amount by 75%.

Medical Nutrition Therapy Pricing
The medical nutrition therapy fees are available in Physician Fee Schedule. To determine the fee, multiply the fee amount by 85%. (Exception - The 85% calculation does not apply to Codes G0108 and G0109).

Nurse Practitioner/Physician Assistant/Clinical Nurse Specialist Pricing
The NP, PA and CNS fees are available in the Physician Fee Schedule. To determine the fee, multiply the fee amount by 85%. (Exceptions - The 85% calculation does not apply to codes with a TC modifier, Technical Component Only codes, or CPT codes G0108 and G0109).

2025 Final Rules & Fee Schedules

• 2025 Physician Fee Schedule Final Rule 
• 2025 Physician Fee Schedules 
• 2025 Specialty Pricing 
• Physician Fee Schedule Final Rule Fact Sheet 
• Quality Payment Program Fact Sheet 
• Medicare Shared Savings Program in the CY 2025 PFS Final Rule Fact Sheet 
• Medicare Prescription Drug Inflation Rebate Program Changes Fact Sheet