We all know that one of the biggest challenges that the government faces is the speed at which technology is evolving. Whether it’s the FDA trying to regulate medical devices and new AI applications or whether it’s CMS trying to evolve how they reimburse for various services, it’s a challenge to keep up.
While this is a challenge, it’s still the reality that they face and they continue to try to adapt to the ever changing world. To learn more about some of the recent CMS reimbursement changes for tech-enable therapies, we interviewed Joseph C. Sardano, Founder, Chairman & Chief Executive Officer at Sensus Healthcare. Along with talking about some of these changes and how they can be incorporated into various IT workflows, he also suggests some ways that CMS to continue to improve their reimbursement of quickly evolving tech-enabled therapies. Check out our interview to learn more:
Joseph C. Sardano: I’m the Founder, Chairman, and CEO of Sensus Healthcare, and I’ve spent more than 40 years in healthcare. My passion has always been bringing game-changing technologies to clinicians so they can improve patient care.
Over the years, I helped bring major innovations to market with Johnson & Johnson, Toshiba, GE, and Siemens, from MRI and digital radiography to PET/CT and radiopharmaceuticals.
I launched Sensus Healthcare in 2010. We develop superficial radiation therapy (SRT) systems for non-melanoma skin cancers and other dermatologic conditions, including keloids. SRT is incision-free and office-based.
The treatment enables patients to avoid surgery, minimize scarring, and get back to life faster. Studies show the treatment works well over the long term. That gives patients confidence and real peace of mind.
What do you see are some of the ways that technology is evolving and CMS is struggling to keep up?
Joseph C. Sardano: Over the years, CMS has relied on physician societies, often working through the AMA to influence, and in many cases shape, policy, procedures, and reimbursement. In many cases, those recommendations benefited the physician specialties behind them. CMS adopted those recommendations nearly 100% of the time.
In recent years, CMS has continued to consider these recommendations, but it has become more aware of the cost implications. As a result, the process has come under greater scrutiny. CMS has become more disciplined about what it accepts from the AMA. I’ve seen increased awareness and, overall, better decisions.
As healthcare and patient needs continue to evolve, CMS should include manufacturers in this equation, not just physician groups.
How have the new codes from CMS evolved to better account for healthcare IT in outpatient care?
Joseph C. Sardano: The buzz is building around superficial radiation therapy (SRT) in dermatology, but the industry must remain mindful of self-serving groups that seek to control the adoption of new technologies. These groups can exert significant influence over patient care in order to protect their financial interests at the expense of patient outcomes.
What were the previous workflows and processes for reimbursement, and what do they look like with the new codes?
Joseph C. Sardano: The new codes make reimbursement for treating skin cancer and keloids far more straightforward. The gray area is gone. Physicians can see exactly how they’ll be paid, and payers have clearer guidance on what’s required.
Effective January 1, 2026, CMS revised billing for Superficial Radiation Therapy (SRT) used to treat nonmelanoma skin cancers (NMSC). CMS introduced dedicated CPT codes 77436 and 77437, replacing older, less specific codes such as 77401 and G6001. These new codes allow for more accurate reporting and higher reimbursement, and CPT 77437 requires use of a KX modifier.
How are you seeing EHR and billing systems evolve to better integrate things like clinical decision making and documentation with billing? What else would you like to see done?
Joseph C. Sardano: EMR systems are essential for any physician practice to run the business effectively. In my view, dermatology still lags with much in the healthcare industry in adopting the kinds of modern technologies that are now common elsewhere.
Overall, I see device manufacturers doing too little to help practices improve productivity and fully integrate new tools into the clinic workflow. Until everyone in dermatology is held to clear standards for technical integration, so patient data and practice management systems can work together seamlessly, the specialty will continue to be behind the eight ball.
What else would you like to see done by CMS to continue to facilitate tech-enabled therapies in outpatient care?
Joseph C. Sardano: CMS has issued clear reimbursement guidance that enables dermatology practices to deliver this technology to patients. However, a small number of self-interested groups continue to interfere with patient access and slow adoption. That needs to stop. Any coordinated efforts to obstruct proven, clinically valuable technology, especially when they delay patient care, should be met with appropriate scrutiny and consequences.
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