Imaging Fee Schedules Updated for 2025-26

- The shift to outpatient settings now accounts for approximately 40% of all radiology volume, with growth in this sector outpacing the overall radiology market. - Federal "site-neutral" payment policies continue to be a factor, with proposals aiming to equalize reimbursement between hospital outpatient departments and freestanding centers, which could shift billions in Medicare reimbursement. - Underscoring reimbursement volatility, the 2026 Hospital Outpatient Prospective Payment System (HOPPS) final rule reduced payment by 57% for single SPECT scans (CPT 78803) by reassigning the procedure to a lower-level payment classification. - A long-term analysis of Medicare reimbursement for the 20 most common lower extremity imaging procedures between 2005 and 2020 found an inflation-adjusted decrease of 32.41%. - In response to these pressures, many health systems are pursuing joint ventures with or acquisitions of freestanding imaging center companies to retain patient volume and expand their outpatient footprint. - Market forecasts predict advanced imaging will see significant growth over the next decade, with PET volumes projected to increase by 23%, ultrasound by 16%, and CT by 15%. - A key operational challenge is the growing "experience complexity gap," as more early-career technologists enter the workforce while fewer seasoned staff are available to provide guidance on more complex cases and advanced equipment. - Industry consolidation is accelerating as reimbursement cuts, rising equipment costs, and regulatory burdens drive independent imaging centers to be acquired by larger, multi-site operators.