ACR Supports MARCA Bill Clarifying Radiologist Assistant Payment, Role and Scope of Practice

The American College of Radiology^® (ACR^®) supports passage of the Medicare Access to Radiology Care Act (S. 4624). “MARCA” calls for Medicare payment directly to the radiologists for services in which radiologist assistants (RAs) participated. If passed, MARCA would enable RAs to furnish services when delegated by and under the supervision of a radiologist in jurisdictions authorizing radiologist assistants to practice. The bill also defines RA training and scope of practice.

• Medicare Payment Is for Services Rendered by A Radiologist-Led Team – that Includes an RRA Component.
• RAs Do Not Supervise nor Interpret Exams.
• RAs Are Not Independent Practitioners.
• RAs Always Practice Under the Supervision of a Radiologist.

“The RA is very different from other physician extenders in payment, training and clearly-defined scope of practice,” said Christoph Wald, MD, PhD, MBA, FACR, chair of the ACR Board of Chancellors. “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.”

ACR Opposes Imaging Supervision or Interpretation by Any Non-Physician Provider

RAs are trained radiographers who can extend the reach of on-site radiologists and enable radiologists to focus on the services only these highly-trained physicians can provide – including imaging recommendation, supervision and interpretation.

• RAs complete advanced education and training that includes a rigorous academic program with a nationally-recognized curriculum and a radiologist-directed clinical preceptorship.
• RAs must pass a nationally-recognized certification examination and complete continuing education programs. No other non-physician practitioner gets as much specialized training in radiology services.

“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,” said Dana H. Smetherman, MD, MPH, MBA, FACR, CEO of ACR.

The College worked with the American Society of Radiologic Technologists (ASRT), Society of Radiology Physician Extenders (SRPE) and the American Registry of Radiologic Technologists (ARRT) to create the RA role and all support the passage of MARCA.

After prolonged dialogue with ACR membership and other imaging stakeholders, the ACR Council voted in 2025 to move forward from the previous neutral stance regarding RA usage. In accordance with this policy passed by the ACR Council, the College supports passage of this legislation to help ensure radiology practices who employ RAs are adequately reimbursed under Medicare for services RAs provide.

For more information or to speak with a spokesperson, contact ACR Public Affairs at PR@acr.org.