Interventional Radiologists Push Back on Medicare’s Value-Based Payment Proposal
The Society of Interventional Radiology (SIR) is raising objections to a recent Medicare proposal that would shift interventional radiologists (IRs) further into value-based care frameworks. The concerns follow the release of the proposed Medicare Physician Fee Schedule by the Centers for Medicare & Medicaid Services (CMS) on July 14.
At the core of the proposal is the creation of a new interventional radiology-focused Merit-Based Incentive Payment System (MIPS) Value Pathway (MVP)—a reporting structure designed to streamline quality reporting through a specialty-specific lens. CMS intends for the MVP to align performance metrics more closely with the unique services provided by interventional radiologists.
However, SIR remains firmly opposed to the current version of the MVP. “SIR previously sent a letter during the public comment period in January 2025 opposing this proposal and SIR remains concerned that the [MIPS Value Pathway] does not adequately reflect the diversity and highly subspecialized nature of IR,” the society stated in a July 17 news update.
According to the Society, the proposed IR MVP includes 24 reporting measures—11 related to quality, 10 to improvement activities, and three tied to cost. Yet, only three of these measures are considered broadly applicable to interventional radiologists at large. The majority, SIR noted, pertain to subspecialties such as stroke intervention, dialysis access, venous therapies, and women’s health.
“The exclusion of broadly applicable quality measures and the reliance on cost measures that do not fairly represent IR contributions further limit the feasibility of this [MIPS Value Pathway],” SIR emphasized. “SIR will provide CMS feedback through the comment process to ensure the MVP evolves into a more inclusive and practical framework that truly supports quality improvement and value-based care across the full spectrum of IR practice.”
The MIPS program, launched in 2017, was designed to incentivize high-performing physicians while promoting cost control. Yet many radiologists have struggled to participate meaningfully due to the limited number of applicable performance metrics and the specialty’s often indirect interaction with patients. A recent study published in February found that smaller practices and solo radiologists are particularly vulnerable to challenges under the current MIPS model.
In its analysis of the proposed rule, the American College of Radiology (ACR) also outlined broader MIPS-related updates. SIR published its own breakdown of the 2025 fee schedule proposal, which includes 51 new payment codes and nine code revisions impacting interventional radiology.
As CMS accepts public comments and prepares for potential implementation, interventional radiology leaders are calling for a more inclusive, realistic payment model that aligns with the field’s procedural diversity and evolving role in patient care.