Access to Pediatric Technologies Act of 2025
Access to Pediatric Technologies Act of 2025
Plain Language Summary
# Access to Pediatric Technologies Act of 2025 - Summary **What the Bill Would Do** This bill would require Medicare (the federal health insurance program for seniors and some disabled individuals) to create specific payment rates for medical devices designed for children. Currently, these pediatric devices use temporary billing codes, which can create uncertainty about reimbursement. Under this bill, device manufacturers could request that Medicare establish permanent payment methodologies for their pediatric products, based on pricing data and usage information they provide. **Who It Affects** The bill primarily affects manufacturers of FDA-approved medical devices used in pediatric care, as well as healthcare providers who treat children and bill Medicare for these technologies.
Indirectly, it could impact children covered by Medicare and the overall Medicare budget, depending on how many devices receive new payment rates and at what cost. **Current Status** The bill (HR 1931) is sponsored by Rep. John Joyce (R-PA) and is currently in committee, meaning it has not yet advanced to a full House vote. It remains in the early stages of the legislative process.
CRS Official Summary
Access to Pediatric Technologies Act of 2025This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish, upon request, specific payment methodologies for qualifying pediatric technologies under the Medicare physician fee schedule. Qualifying pediatric technologies are medical devices that are (1) covered under Medicare, (2) approved by the Food and Drug Administration, (3) currently billed using a specified temporary billing code for emerging technologies, and (4) predominantly used or specifically designated for pediatric patients.The CMS must develop a payment methodology for a qualifying pediatric technology upon request from the manufacturer and based on available data, including pricing information and claims data. Manufacturers must include relevant information in their requests to enable the CMS to develop the corresponding methodologies.
Latest Action
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.