Initial House budget proposal includes radiologist Medicare pay hike

A congressional budget proposal released Sunday includes a radiologist pay hike for fiscal 2025 in the Medicare program. 

The House Committee on Energy and Commerce issued initial documents, which lawmakers started to markup on May 13. Under the proposal, radiologists and other physicians would see an annual pay update tied to the Medicare Economic Index (MEI)—a measure of medical practice cost inflation currently at 3.5%. 

For 2026, the update would be 75% of MEI and 10% every year from 2027 onward, notes Adam Bruggeman, MD, advocacy chair for the American Academy of Orthopaedic Surgeons. The Radiology Business Management Association said it welcomes the proposed change, though it believes more is needed to preserve patient access to imaging. 

“This reflects the outcome of sustained advocacy, but it is not the end of the fight,” Kit Crancer, chair of the RBMA's Radiology Patient Action Network (RPAN), told Radiology Business Tuesday. “Significant challenges remain, and reimbursement levels continue to fall short of what is needed to support access and sustainability. This policy change, while limited, puts us in a stronger position to press for broader reforms in 2027 and beyond.”

Under the proposed formula, the conversion factor used to calculate physician payments would increase 2.625% in 2026, Ed Gaines, an attorney and health policy expert with Zotec Partners, noted May 12. “Presumably,” he added, there is nothing in the budget bill to address the 2.83% conversion factor cut physicians faced this year. 

“Congress has to do better than that to maintain patient access to care,” Gaines, the vendor’s VP of regulatory affairs, wrote on social media. 

In a follow-up post, AAOS’ Bruggeman said he believes the proposed numbers are “a reflection of the difficulty in achieving sufficient savings in the budget to offset a full MEI increase” for physicians. 

“The number was always going to be less than MEI. Even the hospitals and [ambulatory surgery centers] receive a market basket update less a productivity adjustment,” the spine surgeon wrote. “Personally, I would have preferred a full MEI update for as many years as were allowed under the budget and then giving us time to work on Medicare Advantage and site-neutral reform to pay for a long-term fix,” he added later. 

Alaska-based radiologist Ned Holman, MD, also responded to the discussion. He noted that, in years when the Medicare Economic Index is greater than 2.5%, the proposed change would amount to a pay bump. However, when MEI inflation is less than 2.5%, “we’re actually getting a pay cut versus the baseline scenario of [the Medicare Access and CHIP Reauthorization Act].”

“Everyone who wasted money going into [Alternative Payment Models] now gets screwed over too,” he added. 

The American Hospital Association said late Tuesday that it expected the Energy & Commerce Committee’s markup to last “well into the night or tomorrow morning.” Lawmakers on E&C have been instructed by the administration to reduce deficits by $880 billion, “with significant Medicaid changes and cuts being considered.” 

“The AHA is greatly concerned about the significant disruption this policy change will have on states’ ability to fund their Medicaid programs,” the association said May 13. “We believe the proposed restrictions on provider taxes fail to recognize the critical role they play in closing significant gaps in the cost of care for essential services.”