Medicare payment advisors urge Congress to increase radiologist reimbursement

The Medicare Payment Advisory Commission on Thursday voted to recommend a reimbursement increase for radiologists and other physicians in 2027, drawing praise from the industry. 

MedPAC, an independent panel of experts that advises Congress on payment policy, is endorsing an additional 0.5% update to doc pay, the American Medical Association reports. That’s on top of what’s currently specified by law—additional increases of 0.25% and 0.75%. 

The reconciliation bill passed by lawmakers last July included a 2.5% pay bump for radiologists and other physicians this year, the association noted. However, it’s set to expire in 2027. 

“Absent meaningful reform, physicians again will face payment cuts, and Congress will once more be forced into last-minute efforts to avert further disruption,” David H. Aizuss, MD, chair of the AMA Board of Trustees, said in a statement Jan. 15. 

Doc lobbying groups have for years fought or an annual physician pay update tied to the Medicare Economic Index, a measure of inflation in the cost of running a practice. And MedPAC had endorsed this idea in a previous report released last summer, noting Medicare has failed to keep up with rising practice costs. When adjusting for inflation, reimbursement under the federal payment program has fallen 33%, the nation’s largest physician advocacy group estimates.  

“While the AMA agrees with MedPAC’s diagnosis of the problem, it is disappointed that the commission has stepped back from the solution it endorsed just months ago, a point that two commissioners noted today," Aizuss added. “Linking Medicare physician payment updates to MEI as MedPAC itself suggested last June would provide stability for physician practices and certainty for patients, particularly those in rural and underserved communities, that access to their physician won’t be compromised.” 

The American Hospital Association also wrote to the MedPAC chairman on Jan. 9, ahead of the vote, encouraging commissioners to consider a higher update to physician pay. AHA, which represents over 270,000, affiliated physicians, believe Medicare pay needs to increase to more fully account for the impact of inflation. 

A 0.5% update, as commissioners recommended this week, does not do the job, AHA contends. This would amount to an increase of about 1.25% for clinicians in qualifying alternative payment models and 0.75% for others who are not. Yet, projected growth as measured by MEI is expected to be 2.1% in 2027 alone. 

AHA additionally has urged MedPAC to recommend that Congress establish safety-net add-on payments under the fee schedule for services furnished to low-income Medicare beneficiaries. Commissioners had previously made this recommendation in years past, but did not in last year’s draft report. 

“Safety-net providers face particular challenges with remaining financially viable, and as such, we have supported MedPAC’s past recommendations,” wrote Ashley Thompson, the AHA’s senior VP of public policy analysis and development.