MARCA bill revives Medicare hospital claims for radiologist assistants

U.S. Sens. John Boozman, R-Ark., and Ben Ray Luján, D-N.M., have reintroduced the Medicare Access to Radiology Care Act, or MARCA, to expand Medicare reimbursement for radiologist assistant-performed services.

The legislation would allow radiologists to submit Medicare claims for nondiagnostic services performed by radiologist assistants under direct supervision in both hospital and office settings, according to Boozman’s office.

Current Medicare rules recognize radiologist assistants as able to perform services under direct supervision. However, radiology practices cannot submit claims to Medicare for RA-performed services in hospitals, where Boozman and Luján said RAs most frequently work.

CMS adjusted RA supervision requirements in 2019, allowing Medicare reimbursement for services performed by RAs in the office setting. The change did not extend reimbursement to RA services performed in hospitals, according to the senators.

“Medicare patients need timely access to medical imaging, but current guidelines continue to limit providers’ ability to utilize this important diagnostic tool,” Boozman said.

The proposal has appeared in prior congressional sessions. Congress.gov records show earlier versions introduced in 2017, 2019, 2021, and 2024, with the 2024 Senate bill referred to the Senate Finance Committee.

Supporters listed by Boozman’s office include the American College of Radiology, American Registry of Radiologic Technologists, American Society of Radiologic Technologists, Society of Radiology Physician Extenders, Association for Medical Imaging Management, RAYUS Radiology, and Arkansas radiology and radiologic technology groups.

The Radiology Business Management Association lists MARCA among its 2026 advocacy priorities, saying it supports passage of the measure to ensure Medicare reimbursement for services performed by qualified radiologist assistants under direct supervision.

ASRT describes radiologist assistants as midlevel providers in medical imaging and radiation therapy who perform procedures under direct radiologist supervision. Its MARCA materials state that RAs must hold a master’s or doctoral degree, be certified and registered with ARRT in radiography, have at least 2 years of full-time clinical radiography experience, and complete an ARRT-approved RA education program.

“Qualified RAs are already playing an important role in delivering care, and Medicare policy should reflect that,” Luján said.