CMS Makes Virtual Direct Supervision Permanent.

In the rapidly evolving field of virtual contrast supervision, cutting-edge technology and advanced telehealth capabilities often take center stage. However, the unsung hero in this process is the radiologic technologist. Without a well-trained and confident radiologic technologist on the front line, even the best virtual supervision systems cannot deliver their full potential.

As of 2026, new updates from both the American College of Radiology (ACR) and Centers for Medicare & Medicaid Services (CMS) have solidified the role of virtual contrast supervision across a wide range of imaging settings. With these changes, more imaging centers and hospitals are actively evaluating how to implement virtual supervision in a way that meets compliance standards, protects patient safety, and maintains operational efficiency.

As the Centers for Medicare & Medicaid Services (CMS) continues to evolve policies supporting virtual care, the newly proposed CY 2026 Medicare Physician Fee Schedule introduces several key updates that could significantly impact how imaging centers and hospitals deliver contrast supervision. At ContrastConnect, we view these proposals as a positive step toward cementing remote supervision as a safe, compliant, and scalable standard of care.

The advanced copy of the CY 2026 Medicare Physician Fee Schedule proposes making Virtual Supervision Permanent

As healthcare delivery models evolve, many hospitals are turning to remote solutions to improve efficiency, reduce staffing bottlenecks, and maintain high standards of patient care. One area seeing rapid transformation is contrast supervision in imaging departments, where the shift to virtual support has become a practical, safe, and compliant alternative to traditional in-person models.

Modern imaging deserves modern policy. AB460 is a step in the right direction.

Virtual contrast supervision has rapidly transitioned from a temporary solution for imaging centers to a transformative standard in diagnostic imaging that is revolutionizing workflows. Initially adopted during the COVID-19 pandemic on a temporary basis, its widespread success has led to near-unanimous industry support to make it permanent.

Administering contrast media is a sensitive and highly regulated process that has historically demanded the oversight of a qualified medical professional on-site. However, with the rise of virtual contrast monitoring solutions, imaging centers now have the opportunity to streamline operations, cut costs, and expand their hours of operation through the use of this powerful technology.

In November 2024, the Centers for Medicaid and Medicare Services extended the use of remote contrast supervision and telecommunications through 2025, with the extension slated to expire December 31, 2025.

Using an unpublished version of the final rule, the Centers for Medicare & Medicaid Services has extended the authorization for virtual supervision of Level 2 diagnostic tests until December 31, 2025. It is a promising extension to virtual supervision and its possibility of a permanent installation within medical facilities across the U.S..

The RBMA advocates for making virtual supervision in radiology permanent to improve patient access and response times amid a radiologist shortage.

Centers for Medicare & Medicaid Services (CMS) extended the allowance for remote monitoring of specific diagnostic imaging exams through December 2025.

The American College of Radiology (ACR) released an updated statement on February 26th, 2024 on the supervision requirements for contrast media.

American College of Radiology (ACR) urged the Centers for Medicare and Medicaid Services (CMS) to make virtual supervision of diagnostic tests permanent.

CMS approves extending virtual direct supervision through the end of 2024.

The American Society of Radiologic Technicians states that medical imaging and radiation therapy professionals can administer medications other than contrast media under the supervision of a physician. 

Contrast supervision refers to direct supervision by a qualified healthcare professional during medical imaging procedures involving the administration of contrast agents.

ContrastConnect is shaping the future of contrast supervision by offering cost saving solutions to imaging centers while prioritizing patient safety.

This article goes into detail about the key requirements for contrast media supervision, including recent changes to CMS and ACR guidelines, and the importance of compliance.