# Plain Language Summary: Access to Pediatric Technologies Act of 2025

This bill makes it easier for children to access new medical devices by streamlining how Medicare pays for pediatric technologies. Right now, when a new medical device designed for children comes to market, there's often a delay before Medicare establishes a payment rate for it. This can create a gap where hospitals and doctors are unsure how much they'll be reimbursed, which sometimes discourages them from using the technology even though it could help kids. This bill fixes that by requiring the government to set payment rates for new pediatric devices more quickly and predictably.

Here's how it works in practice: When a medical device company develops a new technology specifically for children—like a specialized surgical tool or diagnostic device—they can submit a request to Medicare asking for a payment rate. If the request comes in by May 1st of any year, Medicare will establish a payment rate that same year. If it comes later, they'll do it the following year. The payment will be based on available information like pricing data, insurance claims, time studies, and other relevant costs. This gives manufacturers a clear timeline and removes uncertainty about reimbursement.

The bill only applies to devices that meet specific criteria: they must be FDA-approved or cleared, covered by Medicare, assigned a temporary code for new technologies, and either used mainly on children or specifically designed for pediatric safety and effectiveness. Importantly, the bill doesn't guarantee that Medicare will cover every pediatric device—it just speeds up the payment rate process for those that already qualify. This means children and their families should have faster access to innovative medical technologies that could improve their care, while hospitals and doctors have the certainty they need to invest in these tools.

Access to Pediatric Technologies Act of 2025

Joyce, John

Access to Pediatric Technologies Act of 2025This bill requires the Centers for Medicare &amp; Medicaid Services (CMS) to establish, upon request, specific payment methodologies for qualifying pediatric technologies under the Medicare physician fee schedule.&nbsp;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.