Radiologists tout support for bipartisan bill to address interventional ‘payment crisis’

Radiologists and other docs are voicing support for a bipartisan bill aimed at addressing a brewing “payment crisis” among interventional specialists. 

Reintroduced by representatives in March, the Promoting Fairness for Medicare Providers Act seeks to smooth out reimbursement differences between office-based settings and hospital ambulatory surgery centers. Lawmakers contend these variances hinder radiologists and other physicians, unintentionally limiting where certain procedures can be performed.

Twelve national physician associations including the Society of Interventional Radiology on Tuesday touted their strong support for the bill. They noted that in 2025, Medicare reimbursement fell below the direct cost of care for over 300 common office-based CPT codes—before even accounting for overhead, malpractice expenses and physician work. 

“Every year, we absorb more and more of the cost of caring for our Medicare patients out of our own pockets,” Robert Tahara, MD, a vascular surgeon and board member of the Office-Based Facility Association, said in a statement June 9. “We are not asking for a windfall—we are asking to be paid what it actually costs to provide the care. [House Resolution] 7863 gives independent physicians a fighting chance to keep their doors open and keep patients out of hospitals for procedures that can safely and more affordably be done in our offices.”

The association also represents physicians across specialties including interventional cardiology, radiation oncology, nephrology, pain medicine and phlebology. They note the fee schedule was designed to reimburse docs for their professional work, “not to cover the high-cost supplies and specialized equipment now routinely used in modern office-based procedures.” This has resulted in a “deepening reimbursement crisis” now building for nearly 20 years. 

Office-based reimbursement for the 300 underpaid procedure codes has fallen 22% since 2019, radiologists and other docs estimate. This while hospital outpatient rates for the same services rose 22%, a 44-point swing. On average, hospital outpatient departments are paid 124% more than independent offices for the same 300 procedure codes. SIR and others contend this chasm is forcing independent practices to close or consolidate, funneling even more business to hospitals where care costs 2 to 3 times more. Rural and underserved communities are bearing the brunt, the physician groups contend. 

H.R. 7863 fixes this by creating a new “office-based facility” payment category for surgical procedures with supply costs greater than $500. It would pay at approximately 90% of ambulatory surgery center rates using annually updated, “auditable” cost data. The bill also removes high-cost medical supplies from what radiologists believe are “antiquated” practice expense methodology, relying on “flawed” survey data from 2008. Additionally, the legislation would seek to preserve patient access to office-based interventional care, maintaining this setting as Medicare’s lowest-cost site of service. 

The physician coalition also wrote a letter to the bill’s four co-sponsors on May 12, applauding their efforts while underlining the urgency. Those reintroducing the Promoting Fairness for Medicare Providers Act on March 9 included Reps. Gus Bilirakis, R-Fla., Raul Ruiz, MD, D-Calif., Greg Murphy, MD, R-N.C., and Danny Davis, D-Ill. Meanwhile, other societies voicing their support on June 9 included the American Association of Clinical Urology, American College of Radiation Oncology, American Society of Diagnostic and Interventional Nephrology, American Society of Pain & Neuroscience, American Society of Nephrology, American Vein & Lymphatic Society, American Venous Forum, the Outpatient Endovascular and Interventional Society, Society for Cardiovascular Angiography and Interventions, Society for Vascular Surgery, and the Renal Physicians Association.