PlainBillCongress, translated.Legislation. Context. Public interest.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.
Congressional Research Service
Version 00 · Introduced in House · Mar 6, 2025
Access to Pediatric Technologies Act of 2025
This 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.
People & committees
Rep. Joyce, John [R-PA-13] · R–PA
Legislative record
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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.
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.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
Source last updated: Feb 13, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2025-03-06 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The proposed Access to Pediatric Technologies Act of 2025 would let manufacturers of qualifying pediatric medical devices request national payment weights under the federal physician fee schedule. These weights help determine payment amounts. The Secretary would have to establish them where none exist, but the bill would not itself require coverage of the devices.
This Act may be cited as the Access to Pediatric Technologies Act of 2025.
the Secretary shall, upon receipt of a manufacturer request under paragraph (3), establish national relative value units under the physician fee schedule established under this section, to the extent no such national relative value units have been established for such qualifying pediatric technology under such fee schedule.
in accordance with the payment methodology established under this section and applicable regulations
Nothing in this subsection shall be construed to require coverage of a qualifying pediatric technology under this title
The proposed requirement would apply to qualifying technologies furnished on or after January 1, 2026. It would require a manufacturer request and would apply only where national relative value units—the payment weights—have not already been established.
For each qualifying pediatric technology (as defined in paragraph (4)) furnished on or after January 1, 2026, the Secretary shall, upon receipt of a manufacturer request under paragraph (3), establish national relative value units under the physician fee schedule established under this section, to the extent no such national relative value units have been established for such qualifying pediatric technology under such fee schedule.
To qualify, a medical device would have to satisfy each of the following requirements, together with the pediatric-use requirement described below: coverage under the referenced Social Security Act title; approval, clearance, or authorization under one of the listed Federal Food, Drug, and Cosmetic Act provisions; and a temporary Level I HCPCS code intended for emerging technologies, services, or procedures.
the term qualifying pediatric technology means a medical device that is— (A) covered under this title; (B) approved, cleared, or authorized under section 510(k), 513(f)(2), or 515 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360(k), 360c(f)(2), 360e); (C) described by a temporary Level I HCPCS Code intended for emerging technologies, services, or procedures
The device would also have to be used in a procedure performed predominantly on pediatric patients, or be specifically designed for safe and effective use in pediatric populations. Either pediatric-use condition would suffice, alongside the other eligibility requirements.
and (D) (i) used as part of a procedure predominantly performed on pediatric patients; or (ii) has otherwise been specifically designed for safe and effective use in pediatric populations.
The Secretary would have to use the existing payment methodology and applicable regulations to establish the weights. Available evidence could include contractor pricing, claims data, time and motion studies, invoice information, and other information used to set payment rates.
The Secretary shall establish national relative value units for a qualifying pediatric technology under this subsection— (A) in accordance with the payment methodology established under this section and applicable regulations; and (B) using available data related to the qualifying pediatric technology, which may include applicable contractor pricing information, claims data, time and motion studies, invoice information, or other information used by the Secretary in establishing payment rates.
Manufacturers would have to submit written requests with information verifying eligibility and supporting calculation of the payment weights. Supporting pricing, claims, study, invoice, or other relevant information would have to be included to the extent available. The Secretary would establish the weights through the annual physician fee schedule rulemaking process.
Upon written request to the Secretary from the manufacturer of a qualifying pediatric technology, the Secretary shall establish national relative value units under paragraph (1) through the annual rulemaking process for the physician fee schedule established under this section, in accordance with the timeline described in subparagraph (B).
A manufacturer submitting a request under paragraph with respect to a qualifying pediatric technology of the manufacturer shall include in such request information to verify that the technology is a qualifying pediatric technology and to allow the Secretary to establish national relative value units for such technology, including (to the extent available) contractor pricing information, claims data, time and motion studies, invoice information, or other relevant information.
For requests received on or before May 1, the Secretary would have to establish the payment weights in that year's physician fee schedule rulemaking. For requests received after May 1, the Secretary would have to establish the weights in the following year's rulemaking.
In the case where the Secretary receives a request under this paragraph on or before May 1 of a given year from a manufacturer with respect to a qualifying pediatric technology of the manufacturer, the Secretary shall establish national relative value units for the qualifying pediatric technology in the rulemaking process during that year for the physician fee schedule established under this section.
In the case where the Secretary receives a request under this paragraph after May 1 of a given year from a manufacturer with respect to a qualifying pediatric technology of the manufacturer, the Secretary shall establish national relative value units for the qualifying pediatric technology in the rulemaking process during the following year for the physician fee schedule established under this section.
Establishing payment weights would not itself require coverage of a device. The proposal also expressly preserves the requirements of Social Security Act section 1862(a)(1)(A).
Nothing in this subsection shall be construed to require coverage of a qualifying pediatric technology under this title or alter the requirements of section 1862(a)(1)(A).
The supplied official-actions snapshot, updated February 13, 2026, records introduction in the House on March 6, 2025, and referral that day to the Energy and Commerce and Ways and Means Committees for provisions within their respective jurisdictions.
Source snapshot updated 2026-02-13T21:04:43Z.
2025-03-06: Introduced in House
2025-03-06: 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.
A closer look
Reviewed version: Introduced in House · 2025-03-06. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy attached to appropriations was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials. The source set does not establish formal earmark status.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow carve-out, special exemption, or preferential exception beyond the main policy's intended coverage was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Full text preserved for this analysis. Legislative record snapshot: Feb 13, 2026. How PlainBill uses AI