Society of Radiology Physician Extenders

Medicare Access to Radiology Care Act 2019- HR 1970

April 25, 2019

Rep. Mike Doyle introduced H.R. 1970, the Medicare Access to Radiology Care Act, on March 28, 2019. The legislation would allow radiologists to submit claims to Medicare for non-imaging services performed by radiologist assistants in hospital and office settings, as well as imaging services in hospitals. Reps. Pete Olson, Ron Kind, Greg Gianforte, John Sarbanes, and Terri Sewell serve as co-sponsors of the bipartisan bill.

If enacted, MARCA would offer Medicare recognition of RAs as midlevel providers of health care services working under the supervision of a radiologist. The MARCA bill is another positive step toward RA recognition at the federal level. In November 2018, the Centers for Medicaid and Medicare Services revised the Physician Fee Schedule to allow RAs to practice under “direct supervision” levels. The change followed significant advocacy efforts targeting CMS by SRPE and other radiology stakeholders.

Please contact your Representatives to co-sponsor this important legislation. A sample letter can be found here and maybe modified for your practice.

The SRPE, ARRT, and ASRT is organizing a RA on the Hill day in Washington DC for May 20-21st, to run in conjunction with the ACR's Hill Day which is May 22nd.The SRPE would like to ask that you contact your Congressperson's district offices those days and ask him/her to cosponsor HR 1970 MARCA.

CMS Final Rule Guiding Documents Released

December 22, 2018

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) finalized a policy in the Medicare Physician Fee Schedule (MPFS) which decreases regulatory burden for the radiology care team.

Specifically, the final rule provides that, effective for services furnished on or after January 1, 2019, diagnostic tests requiring personal physician supervision may be performed under direct physician supervision when furnished by a radiologist assistant (RA) either certified as a registered radiologist assistant (R.R.A.) who is certified by the American Registry of Radiologic Technologists, or a radiology practitioner assistant (RPA) who is certified by the Certification Board for Radiology Practitioner Assistants to the extent permitted by state law and state scope of practice regulations.

According to Pam Kassing, ACR Senior Economics Advisor, the only thing that can not be billed to Medicare by the radiology practice is procedures (CPT codes 10000-69999) done by RAs on Medicare patients in the hospital setting. However, the RAs can legally practice and do all procedures. The radiology groups and hospitals can bill everything to the private payers. Legislation is still needed for radiology groups to bill Medicare for procedures (CPT codes 10000-69999) in the hospital setting.

For proper coding and billing, the radiologist should include in the report-"Procedure performed by (RA's name and credentials) under the (personal, direct, general) supervision of (radiologist's name and credentials)."

The SRPE, ACR, ARRT, and ASRT has developed an Q&A document to help answer some of the questions regarding the implementation of the Final Rule. In the Q&A document, there is also a chart describing billing for each practice setting, employer of the RA (group or hospital), and test or procedure. As the SRPE gets more information we will publish additional guidance.

See the full Q&A document here

See a Document on "Incident to Rules"

See all documents available for download regarding the CMS rule here

Email any specific questions to This email address is being protected from spambots. You need JavaScript enabled to view it.

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