Senators reintroduce bill to expand reimbursement for radiologist assistants
Senators on May 21 reintroduced legislation aimed at boosting reimbursement for radiologist assistants.
U.S. Sens. John Boozman, R-Ark., and Ben Ray Luján, D-N.M., are again proposing the Medicare Access to Radiology Care Act, commonly referred to as MARCA. Previously introduced in 2024, MARCA would allow physicians to submit claims to Medicare for nondiagnostic services performed by registered radiologist assistants under direct doc supervision.
Boozman and Luján highlighted ongoing provider shortages nationwide, hoping the policy change will help bolster Medicare beneficiaries’ access to medical imaging services. 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.”
“Medicare patients need timely access to medical imaging, but current guidelines continue to limit providers’ ability to utilize this important diagnostic tool,” Boozman said in a statement May 21. “We can remedy that by ensuring radiologist assistants, who are well qualified to assist on diagnostic and therapeutic radiology procedures, have the same opportunity whether in a hospital or doctor’s office.”
Lawmakers also previously introduced MARCA multiple other years including 2021, 2019 and 2017. Some radiologists voiced opposition to the legislation five years ago, expressing concern that more technologists would opt to work, instead, as radiologist assistants, draining the supply of such professionals. They also shared worries that bill would lead to a slippery slope of RAs taking on more duties and potentially seeking independence from rad supervision.
The American College of Radiology in years past has remained neutral on the legislation, given the diversity of opinions among its membership. However, the two senators on Thursday listed ACR among its supporters. ACR on Friday officially announced its support for the bill. Its support comes after the ACR Council voted in 2025 to "move forward from the previous neutral stance regarding RA usage." In accordance with the new policy, the college said it supports passage of MARCA "to ensure radiology practices who employ RAs are adequately reimbursed under Medicare. ACR emphasized it still opposes any imaging interpretation or supervision by non-docs (both of which RAs do not do).
“The RA is very different from other physician extenders in payment, training and clearly-defined scope of practice,” Christoph Wald, MD, PhD, MBA, chair of the ACR Board of Chancellors, said in a statement May 22. “This bill would help ensure that RA use can allow more efficient radiology care, maintain physician-led medicine, and help radiology facilities practically meet increased imaging demand while avoiding many pitfalls of non-physician practitioner use.”
Others also endorsing MARCA include the Arkansas Society of Radiologic Technologists, Arkansas Radiological Society, American Registry of Radiologic Technologists, American Society of Radiologic Technologists, 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.
According to the senators, CMS in 2019 adjusted radiologist supervision requirements, allowing providers to be reimbursed by Medicare for services performed by RAs in the office setting. However, the adjustment did not include reimbursement by Medicare for RA services delivered in hospitals. This has created a disparity that negatively impacts imaging care, Boozman and Luján contend. MARCA would address that gap to restore access for patients and remove disincentives that “jeopardize the ability of radiologists to meet demand for diagnosis and treatment.”
"Too many Medicare patients, especially in rural communities across New Mexico, are struggling to access timely care because of healthcare workforce shortages and unnecessary barriers,” Luján added. “Qualified RAs are already playing an important role in delivering care, and Medicare policy should reflect that.”
Editor's note: This story was updated May 22 to include comments from the ACR.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.