Medicare Updates to Reshape Interventional Oncology Reimbursement in 2026

• The Centers for Medicare & Medicaid Services (CMS) finalized the calendar year (CY) 2026 Physician Fee Schedule (PFS); updates reflect recommendations from the Society of Interventional Radiology (SIR), securing several wins for interventional radiology.
• CMS unveiled new guidance on the Wasteful and Inappropriate Service Reduction (WISeR) Model, launching Jan 1, 2026 in 6 states and subjecting select image-guided and interventional services to prior authorization and pre-payment review.
• These policy shifts mean altered reimbursement dynamics and a potential increase in administrative burden—practices in affected states should begin preparing for documentation and workflow changes to avoid delays and denials.

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The Centers for Medicare & Medicaid Services (CMS)’s newly published calendar year (CY) 2026 Medicare Physician Fee Schedule (PFS) final rule and related policy guidance mark significant developments for interventional oncology (IO) and radiology practices nationwide. According to the Society of Interventional Radiology (SIR), several key wins were achieved for interventional radiology (IR) codes and reimbursement valuations.¹ Over the summer, CMS also launched the Wasteful and Inappropriate Service Reduction (WISeR) model—a 6-year payment model targeting services deemed vulnerable to waste, which is set to begin on January 1, 2026 in 6 states.^2,3 Notably, SIR made public its opposition to WISeR on September 22, 2025, citing am increased administrative burden to physicians and the potential resulting consequences for patients, including death.^2,4

In a November 6, 2025, communication,¹ SIR outlined multiple achievements for IR under the CY 2026 PFS final rule. These include:

• Finalization of relative value units (RVUs) and practice expense (PE) inputs for 46 new lower-extremity revascularization (LER) codes—including increased reimbursement for 2 drug-coated balloon supplies and 2 drug-eluting tibial stent supplies, as well as a new angiography supply pack.
• Acceptance of the recommendations from the Relative Value Scale Update Committee (RUC) for certain endovascular therapy with imaging codes, including the recommended vascular interventional technologist clinical time.
• Adoption of RUC-recommended RVUs and PE inputs for prostate biopsy procedures.
• Finalization of the IR Merit-based Incentive Payment System (MIPS) Value Pathway (MVP) as a voluntary reporting option and addition of 7 new quality measures to the IR specialty measure set.
• Finalization of a policy giving teaching physicians increased presence during telehealth services.

Initially announced in June 2025, the WISeR Model was originated by CMS with the purpose of targeting “wasteful and inappropriate” radiology and interventional services, particularly under Medicare Part A and B. The model will apply in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. Under WISeR, providers offering services such as percutaneous vertebral augmentation (PVA) will require prior authorization or face pre-payment review.^2,3 The American College of Radiology (ACR) highlights use of artificial intelligence and machine-learning tools to facilitate reviews and exemptions for high-performing providers by mid-2026.³

For IO services, these regulatory shifts carry meaningful implications. The CY 2026 PFS final rule signals better recognition of certain procedural work and supply-cost components—a positive for IO practices that integrate complex ablative or embolic therapies. However, reimbursement gains are tempered by the broader policy environment shaped by the WISeR Model. IO procedures performed in outpatient or hospital outpatient settings may face heightened administrative scrutiny, especially for selected services flagged as “low-value” use.⁵ Prior-authorization workflows, documentation requirements, and potential pre-payment denials introduce new operational burdens, potentially delaying care or shifting site-of-service decisions. From a patient-care standpoint, IO specialists should be proactive in aligning practice protocols with documentation standards and advocacy efforts to protect timely access.

These dual policy developments—from CMS’s CY 2026 PFS final rule and the WISeR Model—underscore a critical juncture for interventional oncology practice. While the reimbursement updates present tangible wins, the increasing regulatory scrutiny demands operational vigilance. The ACR recommends that practices in affected states begin preparing for documentation and workflow changes, described in the WISeR Provider and Supplier Guide, to ensure unobstructed processing and payments.³

1. 2026 MPFS final rule IR wins! Society of Interventional Radiology. November 6, 2025. Accessed November 11, 2025. https://www.sirweb.org/publications/news/wins-for-interventional-radiology-in-the-cy-2026-medicare-physician-fee-schedule-final-rule/
2. Stempniak M. Medicare releases guidance on new model targeting ‘wasteful’ radiology procedures. Radiology Business. October 24, 2025. Accessed November 11, 2025. https://radiologybusiness.com/topics/healthcare-management/healthcare-policy/medicare-releases-guidance-new-model-targeting-wasteful-radiology-procedures
3. CMS WISeR model: what radiology providers need to know. American College of Radiology. October 29, 2025. Accessed November 11, 2025. https://www.acr.org/News-and-Publications/cms-wiser-model-what-radiology-providers-need-to-know
4. SIR opposition to prior authorization requirements in the WISeR Model. Society of Interventional Radiology. September 22, 2025. Accessed November 11, 2025. https://www.sirweb.org/publications/news/sir-opposition-to-prior-authorization-requirements-in-the-wiser-model/#:~:text=Health%20Policy%20Affairs,patient%2Dcentered%2C%20timely%20care.
5. Stempniak M. Medicare cost-cutting initiative targets ‘wasteful, inappropriate’ interventional radiology services. Radiology Business. July 2, 2025. Accessed November 11, 2025. https://radiologybusiness.com/topics/healthcare-management/healthcare-quality/medicare-cost-cutting-initiative-targets-wasteful-inappropriate-interventional-radiology-services