Medicare Access to Radiology Care Act of 2026
- Sponsor
- Rep. Joyce, John [R-PA-13]
- Committees
- Ways and Means Committee (primary)
- Last action
- Jul 30, 2026
Bottom line
The bill expands Medicare coverage to include services performed by supervised radiologist assistants, aiming to improve access and efficiency in radiology care.
What it actually does
This bill amends Title XVIII of the Social Security Act to authorize Medicare payment for services provided by radiologist assistants (RAs) under the direct supervision of a radiologist. It defines radiologist assistant services and specifies that payment for these services, when furnished in certain facility settings, will be made to the supervising radiologist at a rate comparable to clinical nurse specialists.
Proponents argue
Supporters argue that recognizing radiologist assistants for Medicare payment will remove barriers to care, leverage an existing skilled workforce, and provide value-based, efficient solutions to improve patient outcomes while ensuring safety through strict radiologist supervision. They emphasize that RAs are critical members of the radiologist-led team and do not seek independent practice.
Opponents contend
Critics might raise concerns about the potential for increased Medicare expenditures due to the expansion of covered services, even if proponents argue for efficiency gains. Some may also express apprehension regarding the delegation of services traditionally performed by physicians, even under supervision, citing potential impacts on the perceived quality of care or the scope of practice for various medical professionals.
The bill is concise and clearly written, making it accessible for a quick and informed review by interested parties.
Section 3(a), amending Section 1861(s)(2)(K) and adding (ooo) to the Social Security Act
Medicare Coverage for Radiologist Assistant Services
This provision adds 'radiologist assistant services' to the list of services covered under Medicare Part B. It defines these services as those that would typically be physicians' services, performed by a certified radiologist assistant under the supervision of a radiologist, and legally authorized by the state. It explicitly states that no other provider, besides the supervising radiologist, can charge for these specific services.
Supporters argue
Supporters argue this provision formally recognizes the valuable role radiologist assistants play in the healthcare system, allowing them to contribute more fully to patient care under appropriate supervision. This will enhance access to necessary imaging services, particularly in underserved areas, and improve the efficiency of radiology departments.
Critics contend
Some might argue that expanding coverage to non-physician providers, even under supervision, could lead to concerns about the overall quality of care if not rigorously monitored, or that it could dilute the role of board-certified radiologists. However, the bill's explicit emphasis on supervision and limitations on RA scope mitigates some of these concerns.
Tradeoffs
The provision balances the desire to improve access and efficiency in radiology care by leveraging advanced-level radiographers against potential concerns about maintaining the highest standards of physician-led care and the scope of practice for different medical professionals. The strict supervision requirement is key to this balance.
Section 3(b), amending Sections 1833(a)(1)(O), 1848(a), and 1842(b)(6) of the Social Security Act
Payment Mechanism for Radiologist Assistant Services
This provision establishes how radiologist assistant services will be paid under Medicare. Specifically, for services furnished in a 'covered facility setting' (like hospitals or ambulatory surgical centers), payment will be made to the supervising radiologist. The payment amount will be determined pursuant to the rate applied to clinical nurse specialists, implying a specific reimbursement level that is likely less than a full physician's service but recognizes the RA's contribution.
This clause specifies that for radiologist assistant services to be covered, 'no other provider (other than the supervising radiologist) charges or is paid any amount with respect to the furnishing of such services.'
Section 3(a)(2), adding Section 1861(ooo)(1)(C) to the Social Security Act
Why it matters:This is standard legislative practice to ensure clarity and prevent double-billing or fragmented billing for the same service, which could lead to confusion and increased costs. It reinforces that the payment is for the RA's service under the radiologist's umbrella.
Case for: Proponents would argue this ensures billing integrity, prevents fraud and abuse, and clearly establishes the payment pathway through the supervising radiologist, reinforcing the team-based model.
Case against: No specific case against this provision is typically raised, as it's a standard measure to prevent billing complications. However, some might argue it limits flexibility in billing arrangements, though this is unlikely given the supervisory model.
Estimated impact: Prevents potential billing complexities and ensures a single point of accountability for RA services, contributing to fiscal responsibility within the Medicare program.
This 'Rules of construction' clause explicitly states that the new subsection shall not be construed as affecting coverage or payment for the technical component of imaging services, the amount of payment for physicians' services personally performed by a radiologist, or payment for services furnished by a covered facility setting.
Section 3(a)(2), adding Section 1861(ooo)(3) to the Social Security Act
Why it matters:This is standard legislative practice to clarify the scope and intent of the new law, preventing unintended interpretations or impacts on existing payment structures. It reassures stakeholders that the bill is narrowly targeted.
Case for: Proponents would highlight this as crucial for ensuring the bill does not inadvertently disrupt existing Medicare payment policies for radiologists or facilities, thereby reducing potential opposition and clarifying its limited scope.
Case against: No direct case against this clarification. However, some might argue that by explicitly carving out these areas, the bill misses an opportunity to re-evaluate or reform broader aspects of radiology reimbursement.
Estimated impact: Maintains the stability of existing Medicare payment structures for radiologists' personal services and technical components of imaging, preventing unintended financial consequences for providers.