Victory for ASCs: CMS Removes Burdensome Radiologist Requirement

May 8, 2014

The Centers for Medicare & Medicaid Services (CMS) has removed the provision in the Conditions for Coverage (CfCs) requiring ASCs to have a radiologist on their medical staff. This change was part of a larger pre-published final rule released yesterday entitled, Medicare and Medicaid Programs: Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction. ASCA has long advocated for this change noting that requiring ASCs to have a radiologist on staff does not make sense given that radiologic services in an ASC are generally limited to intra-operative guidance that does not require interpretation by a radiologist. Additionally, ASCs have reported difficulty in finding radiologists that are willing to be part of their medical staff.

Instead of requiring a radiologist on staff, the new language, found at §416.49(b)(2), states:

“If radiologic services are utilized, the governing body must appoint an individual qualified in accordance with State law and ASC policies who is responsible for assuring that all radiologic services are provided in accordance with the requirements of this section.”

The language CMS initially released when the rule was proposed in 2013 would have stated that instead of requiring a radiologist to be on staff, a doctor of medicine or osteopathy on the ASC’s medical staff would be charged with supervising the provision of radiologic services in an ASC. In its comment letter responding to this proposed language, ASCA raised concerns that the proposed requirement was not that different from what was already in place. ASCA requested language giving the governing body authority to appoint the appropriate individual if radiologic services were needed in the facility.

“We are pleased that CMS has responded to our request for a common sense policy pertaining to radiological services in ASCs,” said William Prentice, chief executive officer of the Ambulatory Surgery Center Association. “We look forward to continuing an open dialogue with CMS to identify and remove other burdensome requirements that hinder our ability to serve patients in the most efficient manner possible.”

CMS estimates that the change will save ASCs $41 million annually.

The rule is scheduled to be published on Monday, May 12, 2014, and the change becomes effective 60 days after publication. Click here to view the final rule. The relevant portion begins on page 16.

ASCA will continue to work with CMS to remove other regulatory requirements that are burdensome to ASCs. For more information, please contact Kara Newbury at