The proposed legislation would clarify Medicare reimbursement for radiologist assistant participation in imaging services and formally define the role’s training requirements and practice limitations.
The American College of Radiology is supporting passage of the Medicare Access to Radiology Care Act (S. 4624), or MARCA, legislation aimed at clarifying Medicare payment policies and the scope of practice for radiologist assistants (RAs).
According to the ACR, the bill would allow Medicare payment to radiologists for services in which RAs participated. If passed, MARCA would also allow RAs to furnish services when delegated by and under the supervision of a radiologist in jurisdictions where radiologist assistants are authorized to practice.
The legislation also defines RA training requirements and scope of practice.
The ACR emphasized that radiologist assistants are not independent practitioners and do not supervise or interpret imaging exams. The organization said RAs practice under the supervision of radiologists as part of a physician-led care team.
“The RA is very different from other physician extenders in payment, training, and clearly-defined scope of practice,” says Christoph Wald, chair of the ACR Board of Chancellors, in a release. “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.”
The ACR said it continues to oppose imaging supervision or interpretation by non-physician providers.
According to the organization, RAs are trained radiographers who complete advanced education and clinical training programs, including a radiologist-directed clinical preceptorship. RAs must also pass a nationally recognized certification examination and complete continuing education requirements.
“Unlike some other non-physician providers, the RA’s scope of practice specifically excludes imaging supervision and interpretation. Under MARCA, RAs are only reimbursed as part of a radiologist-led team—not as independent practitioners,” says Dana H. Smetherman, CEO of the ACR, in a release.
The ACR said it worked with the American Society of Radiologic Technologists, Society of Radiology Physician Extenders, and American Registry of Radiologic Technologists to help establish the RA role and said the organizations support passage of the legislation.
The organization also noted that the ACR Council voted in 2025 to move away from its previous neutral stance on RA usage following discussions with imaging stakeholders and ACR members. According to the ACR, the legislation would help ensure radiology practices employing RAs are reimbursed under Medicare for services involving radiologist assistants.
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