Congress Targets Faster Medicare payment rates for certain new pediatric medical devices

Read twice and referred to the Committee on Finance.

Introduced in Senate

Medicare begins applying the new process to qualifying pediatric technologies furnished on or after January 1, 2026

Providers and manufacturers can use this pathway to get a national Medicare payment value for eligible pediatric devices, which may reduce delays in making the technology available.

Manufacturers submit written requests (with supporting data) to Medicare to set a national payment value for a qualifying pediatric device

Companies that move quickly and provide strong evidence may get clearer Medicare payment sooner, which can make providers more comfortable offering the device.

If Medicare receives a manufacturer request on or before May 1 of a year, Medicare addresses it in that year’s annual physician payment rulemaking

Earlier requests can lead to faster national payment clarity, which may speed up patient access in places that follow Medicare’s lead.

If Medicare receives a manufacturer request after May 1 of a year, Medicare addresses it in the next year’s annual physician payment rulemaking

Late requests likely mean an extra year of waiting for a national Medicare payment value, which can delay broad provider adoption.