The U.S. House Ways & Means Committee unanimously advanced, on May 21, a bill that overhauls the way Medicare pays radiologists and other physicians. The Provider Reimbursement Stability Act of 2026, filed as H.R. 8163, would cap annual changes to the program conversion factor at 2.5%. That multiplier ultimately defines how much physicians receive for each procedure billed to the federal program.
What the bill actually changes
The legislation is co-sponsored by Rep. Greg Murphy, MD (R-N.C.), and Rep. Tom Suozzi (D-N.Y.). Beyond the 2.5% cap on annual fluctuations, the proposal raises the threshold that triggers Medicare budget neutrality adjustments from $20 million to $54.3 million. That figure would then be indexed every five years to the Medicare Economic Index, an inflation measure for the cost of operating a medical practice.
In practice, small adjustments to one section of the fee schedule would no longer ripple into automatic cuts across other specialties. Committee Chairman Rep. Jason Smith (R-Mo.) said the bill should help independent physicians keep their doors open and described the existing system as outdated, unpredictable, and a key driver of the consolidation wave that has swept private practice in recent years.
Why radiology pushed hard for the bill
The American College of Radiology, the Society of Interventional Radiology, and the American Society of Neuroradiology issued a joint statement urging Congress to advance the bill. For the societies, the proposal is a necessary step toward a more rational, predictable Medicare payment framework — one that protects patient access to imaging and reflects the real cost of delivering high-quality services.
Their argument rests on a widely cited American Medical Association statistic: when adjusted for inflation, Medicare physician payments have fallen 33% since 2001. The shortfall hits capital-intensive specialties especially hard. Radiology must amortize CT, MRI, and angiography systems that often run into millions of dollars per unit, plus the IT backbone — PACS, viewers, and reporting tools — that keeps the workflow running.
The ACR testimony on Capitol Hill
One day before the committee vote, on May 20, ACR CEO Dana Smetherman, MD, MBA, MPH, testified before the Energy and Commerce Health Subcommittee. The hearing — titled Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reform — gave the college a platform to defend two technical provisions that rarely get headlines: a look-back period to reconcile over- and under-utilization estimates and more timely updates to the direct costs that feed Practice Expense RVUs.
For Smetherman, these are long-overdue statutory fixes. Her position echoes a broader push to modernize payment rules. The radiation oncology community made a similar case in recent coverage of ASTRO and the ROCR law, and a parallel financial debate erupted around SimonMed and its extra fee for AI image analysis.
Expected impact on practices and access
American Medical Association president Bobby Mukkamala, MD, called the committee vote a major step in curing a flawed budget policy. In a May 21 statement, he warned that without reform the Medicare Physician Fee Schedule produces a year-end budget mashup that injects uncertainty into physician practices — particularly in rural and underserved communities where imaging capacity is already stretched thin.
For radiology administrators, the 2.5% ceiling matters because it turns financial planning from reactive to predictable. Today, annual swings can reach double-digit negatives, forcing staffing cuts, postponed PACS upgrades, or shrinking equipment fleets. With stable rules, vendor contracts, maintenance packages, and capital investment strategies gain a clearer horizon.
What happens next
H.R. 8163 now moves to the full House for consideration. Even with bipartisan committee backing, final passage will depend on negotiation in the Senate and an eventual presidential signature. Medical organizations have signaled that they will keep pushing to advance the bill within the 2026 legislative calendar, before the next round of automatic budget adjustments kicks in. The window is narrow: the conversion factor for the following year is normally finalized through the rulemaking process in late summer and fall, so any structural change has to clear both chambers well before that.
A second open question is how the bill will interact with MACRA-era programs such as MIPS and the Advanced APM track. Smetherman has hinted that further reforms will be needed to align the budget-neutrality fix with the broader quality-payment framework. Without that alignment, practices could still see their effective reimbursement shaved by performance adjustments even after the conversion factor stabilizes.
For radiology leaders outside the United States, the outcome matters for two reasons. First, the Medicare fee schedule is a recurring reference point when discussing physician pay and CPT-style coding in other health systems. Second, equipment and software vendors adjust their global strategies based on the U.S. regulatory environment, with direct effects on pricing, product launches, and availability in regional markets — including how aggressively manufacturers price PACS subscriptions, AI add-ons, and CT or MRI service contracts in Latin American tenders.
Source: Radiology Business