Congressmen propose expanding Medicare reimbursement for radiologist assistants

Congressmen have reintroduced legislation in the U.S. House aimed at expanding reimbursement for radiologist assistants to help address workforce shortages. 

Reps. John Joyce, MD, R-Pa., and Mike Thompson, D-Calif., on July 30 proposed the latest iteration of the Medicare Access to Radiology Care Act, also known as MARCA. This follows the introduction of similar legislation in the Senate three months ago. Also proposed in 2024, MARCA would allow physicians to submit claims to Medicare for nondiagnostic services performed by registered radiologist assistants working under direct doc supervision. 

The bill is backed by the American College of Radiology, along with the American Registry of Radiologic Technologists, American Society of Radiologic Technologists and others.  

“With bipartisan support in both the House and Senate, this legislation represents significant momentum toward ensuring Medicare reimbursement policies fully recognize the value of registered radiologist assistants,” ARRT board President Jeff Killion, PhD, said in a statement July 31. “MARCA will help radiology teams deliver safe, high-quality imaging care more efficiently and improve patient access to needed services across the country. We look forward to working with lawmakers and our advocacy partners to advance this important legislation.”  

Joyce and Thompson had not released an official statement about the bill as of Aug. 11. Earlier this year, the supporting U.S. senators highlighted ongoing provider shortages nationwide, hoping the policy update will bolster access to medical imaging. While radiologist assistants are allowed under Medicare rules to perform these services, the radiology practices that employ them are unable to submit claims for RA care in hospitals, “where they most frequently work,” lawmakers noted. 

Attorney Thomas W. Greeson reports that the Senate version of the bill contained a “significant omission: Its payment provisions did not include physician office settings.” Radiology advocates had hoped the House companion bill would correct this error. However, House Resolution 9984 “appears to repeat substantially the same facility limitation.” 

“That is disappointing, particularly because physician offices are increasingly important sites for outpatient imaging and minimally invasive radiology services,” Greeson, a partner with Reed Smith and former general counsel to ACR, wrote in a blog post Aug. 10. 

Greeson noted that both bills define “radiologist assistant services” as care performed by an ARRT-certified RA under a radiologist’s direct supervision. This must be authorized under applicable state law and not separately billed or paid to another provider. It would apply to “covered facility settings” that include hospitals, ambulatory surgery centers and “other providers of services” as designated by HHS. 

The ARRT has previously reported that physician offices were excluded from MARCA because RA work is typically already billed “incident to” a radiologist’s professional services, Greeson wrote. 

“MARCA remains worthwhile legislation. But Congress should expressly include physician offices in its scope rather than assume that incident-to billing adequately addresses office-based RA services,” Greeson concluded. “A statute intended to remove barriers to RA utilization should create a clear, uniform and defensible payment pathway in every appropriate setting where radiologists and RAs provide care.”

U.S. Sens. John Boozman, R-Ark., and Ben Ray Luján, D-N.M., are co-sponsoring the Senate bill. Others also endorsing MARCA include the Arkansas Society of Radiologic Technologists, Arkansas Radiological Society, the Society of Radiology Physician Extenders, Association for Medical Imaging Management and Rayus Radiology. The Radiology Business Management Association earlier this year also listed MARCA as one of its top legislative priorities in 2026.

You can read the text of the House bill here.