ACR Urges CMS to Extend Remote Supervision Permanently
Historical ACR advocacy coverage. CMS subsequently finalized permanent virtual direct supervision for applicable 2026 services; see the final-rule guide for current context.
Tether Supervision
Legal & Regulatory
Update: For the most current regulations and state-by-state updates, visit the Tether Supervision National Policy and Regulation Tracker for Contrast Supervision.
In a meeting on February 12th, representatives from the American College of Radiology (ACR) engaged with leaders from the Centers for Medicare & Medicaid Services (CMS) to again advocate for the permanent adoption of remote supervision for diagnostic tests. The focal point of their discussion was the impending expiration of a rule that currently allows for remote supervision of diagnostic tests, set to conclude by the end of 2024. This rule, introduced in 2020 as a response to the COVID-19 pandemic, enabled providers to supervise diagnostic procedures through audio and visual telecommunications, a practice that has proven beneficial in increasing access to care.
A Balanced Approach to Patient Safety and Care Delivery
In their September 2023 CMS comments, the American College of Radiology (ACR) commented in support for the permanent adoption of a rule that permits the virtual direct supervision of level 2 diagnostic tests. This supervision is enabled through real-time audio/video communication technologies by physicians and, where state laws and scope of practice allow, non-physician providers.
Additionally, to mitigate potential risks and maintain the integrity of patient care, the ACR proposed a nuanced approach, suggesting that while remote supervision should continue, secondary non-physician licensed practitioners, such as registered nurses, should be mandatorily present on-site to assist in case of adverse reactions during diagnostic tests. Details on care provision such as these have become important considerations as CMS considers a permanent virtual supervision rule.
A Decision with Far-Reaching Effects
As CMS deliberates on this proposal, the healthcare community watches closely, understanding that the outcome will significantly impact how diagnostic services are delivered in the future. The ACR’s advocacy efforts reflect a broader recognition of telehealth’s role in enhancing healthcare access and efficiency, potentially paving the way for a more adaptable and patient-centered healthcare system.
For the current federal policy, read CMS Contrast Supervision Requirements in 2026.
