House to evaluate bill on radiologist assistant service claims

por John R. Fischer, Senior Reporter | April 04, 2019
A new bill is asking that providers
be able to submit Medicare claims for
services performed by radiologist
A new bill has hit the floor the of U.S. House of Representatives, calling for Medicare to reimburse claims for imaging and non-imaging services performed by radiologist assistants.

Introduced by Representative Mike Doyle, the Medicare Access to Radiology Care Act (H.R. 1970) would enable providers to submit claims to Medicare for non-imaging services performed by RAs in hospital and office settings, and imaging services performed by those in hospitals.

“In November, CMS revised its Physician Fee Schedule. That adjustment didn’t change what services RAs were allowed to perform, but it did allow them to practice with greater flexibility of radiologist supervision levels," Greg Morrison, M.A., R.T.(R), CNMT, CAE, ASRT associate executive director, told HCB News. "For years, ASRT and many other radiology stakeholders have worked to influence the adoption of supervision regulations appropriate for the RA’s advanced education and certification. Over time, the radiologist assistant has become more widely utilized as a physician extender. Medicare’s position is simply evolving in response to the increasingly important role of the RA.”

Under the new physician fee schedule, RAs may perform services under “direct supervision”, which means radiologists do not need to be present in the room but must be in the facility and immediately available to provide assistance. Practices, however, are not allowed to submit claims to Medicare for services performed by RAs in hospitals and offices.

RAs can perform assessments and procedures, as per their training, but are unable to interpret images or prescribe medications or therapies. Instead, many are tasked with determining if a patient is properly prepped for a procedure, adapting exam protocols for better diagnostic quality, and obtaining patient consent at the beginning of procedures, among other functions.

They also perform exams when radiologists are not available to relieve workload, and allow them to spend more time on image interpretation and diagnosis. In addition, some may be tasked with evaluating image quality and making initial observations, though the supervising radiologists remains responsible for providing a final written report, an interpretation and a diagnosis.

MARCA proposes that Medicare recognize radiologist assistants and radiologist practitioner assistants as midlevel providers of healthcare services that work under the supervision of radiologists.

"It’s still relatively early in the process. H.R. 1970 was introduced March 28 in the U.S. House of Representatives. The bill has been referred to the Committee on Energy and Commerce and to the Committee on Ways and Means," said Morrison. "It’s likely there would be at least one committee hearing before coming to a vote before the House. Then the process would need to be repeated in the Senate."

The bill has garnered support from the American Society of Radiologic Technologists, and more than 100 national, state and local organizations and companies, including the American Registry of Radiologic Technologists, American College of Radiology and the Society for Radiology Physician Extenders.

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