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 primarily for children. Currently, pediatric medical devices use temporary billing codes while the government determines appropriate payment amounts. This bill would speed up that process by allowing device manufacturers to request that Medicare establish permanent payment methodologies based on pricing data and real-world usage information. **Who It Affects** The bill mainly affects manufacturers of pediatric medical devices, Medicare, and potentially children who use these technologies through Medicare coverage.
While Medicare typically covers seniors rather than children, some pediatric patients qualify for Medicare due to disability or other circumstances, and hospitals that treat children may bill Medicare for pediatric devices used in their care. **Current Status** The bill was introduced by Senator Marsha Blackburn (R-TN) and is currently in committee, meaning it has not yet been debated or voted on by the full Senate. It has not advanced further in 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
Read twice and referred to the Committee on Finance.