Medicare proposal eliminates plan to make CT radiation-related quality measure mandatory in 2027
The Centers for Medicare & Medicaid Services is proposing not to make a key radiation-related quality measure mandatory in 2027 following concerns from physicians.
As CT utilization continues to rise, maintaining appropriate image quality while minimizing ionizing radiation exposure can prove difficult. To address this, CMS introduced the “Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography in Adults” quality measure (CMS1074v3). It evaluates the proportion of scans that exceed certain thresholds for image noise or radiation dose across 18 categories.
Voluntary reporting started in January, with mandatory compliance slated to begin in two years. However, the agency has now pivoted and is proposing to maintain the voluntary status indefinitely, according to the 2026 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment Systems proposed rule. The American College of Radiology highlighted the preliminary decision in a news update published Wednesday.
“ACR supports continuing voluntary reporting for this measure, recognizing the technical and operational challenges it presents,” the college said. “At the same time, ACR remains deeply committed to radiation dose safety and monitoring, as demonstrated through longstanding initiatives such as Image Wisely, Image Gently, and the Dose Index Registry.”
Experts highlighted some of the challenges with the measure in research published earlier this year by both the American Journal of Roentgenology and the Journal of the American College of Radiology. Potential challenges include ambiguity around how to manage combination studies in accordance with the measure, potential IT burdens and security concerns, along with how users can contest results they believe are incorrect.
ACR encouraged facilities to still engage with the voluntary measure, where feasible, while acknowledging “implementation may not be practical for all institutions.”
Meanwhile, proponents of the quality measure are still holding out hope that Medicare will again decide to make it mandatory by 2027.
“The program being optional is going to lead to many hospitals not reporting on this measure, which would be such a backslide because that’s what’s really driving adoption,” UCSF's Rebecca Smith-Bindman, MD, who recently published research on radiation effects from CT, told the San Francisco Chronicle. “I’m trying to get the word out to say, ‘Yes, we care about CT doses. We care about safety. These doses should come down.’”
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.