The Medicare Access to Radiology Care Act (MARCA)

The American College of Radiology® (ACR®) remains neutral on the Medicare Access to Radiology Care Act (MARCA — H.R. 3657 /S. 2641 ).

If passed by Congress, MARCA would provide payment to the supervising radiologist for registered radiologist assistant (RRA) services performed in a facility setting; it does not allow for independent RRA practice nor payment.

This legislation currently has little congressional support as evidenced by the following:

  • No congressional committees have held hearings related to MARCA.
  • The Senate and House MARCA bills have only eight cosponsors combined/total.
  • The ACR has not met with members of Congress regarding MARCA.
  • RADPAC, the ACR Association political action committee, has not attended nor held MARCA-specific fundraisers and has not contributed in any way related to MARCA.


Get the study results from the survey team! Hear from a panel of practice leaders and ACR government relations staff where we go from here on MARCA, and how you can get involved in ACR scope of practice efforts. ACR member login required.

MARCA and The Registered Radiologist Assistant (RRA)

The American College of Radiology® (ACR®) actively opposes imaging supervision or interpretation by non-physician providers. In 2002, to meet growing imaging demand and optimize radiologist workload, the ACR worked with radiologic technologist societies to create the Registered Radiologist Assistant (RRA) profession. The ACR continues to work with these societies to ensure that RRAs work as part of a radiologist-led team.

Current Payment for RRA Services

RRAs were recognized by Medicare in 2019 to perform diagnostic imaging services under direct radiologist supervision.

However, radiology practices that employ RRAs cannot submit claims for procedures or other services RRAs perform for supervising radiologists in hospitals where they normally work.

Radiologists also cannot bill Medicare for procedures that RRAs could perform in the office setting where the study is not “incident to” the radiologist.

More Information on the RRA and MARCA