RADIOLOGY

ENFORCEMENT|PAYER POLICY|CODING REFORM| REIMBURSEMENT REALITY

Section analysis by Elina Sabilova, CPC, CFPC, CPMA — Billing Department, WCH Service Bureau

Editorial note: The articles in this section combine confirmed policy developments with analytical interpretation of industry trends. Where statements reflect the authors’ analysis or reported practitioner experience rather than directly verifiable published data, this is indicated in context. This section is intended for informational and educational purposes and does not constitute legal or compliance advice. Readers should consult qualified legal and compliance counsel before making practice decisions.

Radiology is under pressure from every direction simultaneously — and in 2026, the pressure has become impossible to manage reactively.

Federal enforcement risk is materially elevated. The OIG’s May 2026 report on peripheral vascular billing in office-based laboratories put specific dollar figures, specific physician counts, and a clear enforcement recommendation on the table. Interventional radiologists who perform angioplasty, stenting, or atherectomy under Medicare are operating in an environment where audit and enforcement activity is explicitly more likely than it was twelve months ago.

At the same time, payer documentation requirements in radiology are tightening across the commercial market — with UHC’s recent policy updates representing a leading indicator that most practices first encountered operationally. The 2026 CPT code overhaul from ACR is the most consequential coding update in years. And the gap between CMS’s official reimbursement narrative and what radiology groups are actually collecting continues to widen through mechanisms that standard financial reporting does not surface clearly. Each of these four forces is examined in full below.

In this section

OIG Puts Peripheral Vascular Billing Under the Federal Microscope — Interventional Radiologists, This Means You
$105M in flagged payments. 26 physicians. Active FCA enforcement. What every IR practice billing Medicare needs to know and do right now.

UHC Quietly Tightened Radiology Reimbursement — and Most Practices Found Out Through Denials
No press release. No advance notice. The documentation crackdown that arrived through remittance advice — and why it’s only the beginning.

2026 CPT Code Overhaul: What Radiology Billing Teams Need to Implement Now
ACR’s most significant coding update in years hits CT cerebral perfusion, irreversible electroporation, radiation oncology, and AI-integrated imaging workflows all at once.

Radiology Payment Cuts Hidden Inside a “Medicare Increase” — How to Read the Real Numbers
CMS announced increases. Radiology groups are collecting less. The gap between the official narrative and practice-level revenue is real, structural, and growing.