March 31, 2026
Imaging Interpretation Turnaround Time More Than Doubled between 2014 and 2023
A new study from the Harvey L. Neiman Health Policy Institute found that the time between an imaging scan and its interpretation for office/hospital outpatient imaging increased 113% between 2014 and 2023, with most of this increase occurring in 2022 and 2023. The study, published in the Journal of the American College of Radiology (JACR), was based on claims for 2.6 million office/hospital outpatient imaging studies.
The researchers found that mean turnaround time was generally stable between 2014 and 2021 with some year-to-year fluctuation. But, since 2021, turnaround time increased rapidly with 19% and 68% of total increase occurring in 2022 and 2023, respectively. The study found increased turnaround times for all imaging modalities with 2014-2023 increases of 318% for CT, 256% for MR, 140% for ultrasound, and 63% for radiography/fluoroscopy.
“Visually, the increase in turnaround times looks like a hockey stick. It is generally flat with annual fluctuations from 2014 through 2021, and then it sharply increased beginning in 2022,” stated Eric Christensen, PhD, Research Director at the Neiman Institute and lead author of the study.
“With growing shortages of radiologists, reports of delays in interpretation due to capacity constraints are increasingly common in recent years. We studied turnaround times nationally to determine if these reports were isolated or represent a widespread concern,” said Greg Nicola, MD, Hackensack Radiology Group, Member Board of Chancellors and Economics Chair of the American College of Radiology, and study senior author. “The results show that an inflection point has occurred. Turnaround times were stable for many years and then doubled in two years.”
The researchers analyzed turnaround times using Medicare fee-for-service claims from 2014 through 2023. Data for 2024 or after are not yet available.
“Although anecdotal reports from frontline radiologists did not spike until 2025, the urgency presented by delayed diagnosis and treatment caused us to initiate the study with available data through 2023,” said Christoph Wald, MD, Professor of Radiology at the Mayo Clinic, Vice Chair Board of Chancellors and Informatics Chair of the American College of Radiology, and study coauthor. “The magnitude of the turnaround time increases between 2021 and 2023 were somewhat surprising as we expected delays to became problematic after 2023. We will continue to study these trends as more recent data are made available by Medicare.”
The study was limited to office/hospital outpatient imaging because emergency department and inpatient imaging are rightly prioritized for interpretation.
“The potential negative clinical impact of growing turnaround time for the interpretation of imaging must be closely monitored, especially if the trend worsens,” said Cindy Yuan, MD, Assistant Professor of Clinical Radiology at the Indiana University School of Medicine and study coauthor. “We think these results are an early indicator of a worsening problem. If the sudden change in 2022 reflects that there is no remaining capacity for the radiology workforce to absorb new workload, then continued imaging growth will eventually impact patients.”
The study also examined disparities in turnaround times and differences in trends across various socioeconomic factors, such as community income.
“We found that turnaround times were higher for Medicare beneficiaries residing in low-income communities (per capita income <$25,000) compared with high-income communities (per capita income $100,000 or more),” said Michele Johnson, MD, Professor of Radiology and Biomedical Imaging at the Yale School of Medicine, Member Board of Chancellors and Commission for Outreach & Professional Opportunity of the American College of Radiology, and study coauthor. “While turnaround times increased for all income groups, they increased more for the low-income groups worsening already longer turnaround times in these communities as a secondary effect.”
To arrange an interview with a spokesperson, contact Nichole Gonzalez at ngonzalez@neimanhpi.org.
About the Harvey L. Neiman Health Policy Institute
The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care. Visit us at www.neimanhpi.org and follow us on X, BlueSky or LinkedIn.