# JACR: 30.7% of 783,634 CT scans at 254 facilities exceeded the dose threshold on Medicare's ExRad measure

- Published: 2026-11-05 07:03 UTC
- Section: Life & Health › Medicine
- Tags: CT radiation dose, Medicare ExRad measure, excessive radiation dose, CT image quality, JACR study, 254 facilities, 783,634 CT scans, Smith-Bindman, CT protocols, radiology quality reporting
- URL: https://realtech.media/news/rt-e3fd1883c03d98aa3fbb243e_jacr_30_7/

**A study of 254 facilities found that the share of CT scans with excessive radiation dose ranged from under 1% to over 90%, while image quality failures were only 0.06%.**

![JACR: 30.7% of 783,634 CT scans at 254 facilities exceeded the dose threshold on Medicare's ExRad measure](https://thumb.wikimedia.org/wikipedia/commons/thumb/f/f0/Craig_Joint_Theater_Hospital_receives_exclusive_new_CT_scanner_150724-F-QU482-016.jpg/1920px-Craig_Joint_Theater_Hospital_receives_exclusive_new_CT_scanner_150724-F-QU482-016.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
*Senior Airman Cierra Presentado, Wikimedia Commons, Public domain*

On Nov. 3, 2026, the Journal of the American College of Radiology (JACR) published the first study of how imaging facilities perform on the Medicare ExRad measure, according to EurekAlert. The work covers 254 hospitals and imaging practices and 783,634 adult CT scans over 16 months. It found that radiation doses used for the same type of CT scan vary widely from one facility to the next. [1]

## What the ExRad measure showed

ExRad is a Medicare electronic clinical quality measure that evaluates whether a CT scan used more radiation than necessary for the patient's indication or produced images too noisy to interpret. [1] Nearly one in three scans (30.7%) exceeded the radiation threshold for its exam type. Only 0.06% fell short on image quality, so the room for improvement lies in dose, not in picture quality, the authors report. [1]

Facility scores ranged from less than 1% to more than 90% of scans out of range for excessive dose. Three common exam types, routine abdomen and pelvis, chest and head, accounted for 72% of all out-of-range scans. [1]

## Variation within and between facilities

Most facilities performed well on some types of CT and poorly on others. The typical gap between a facility's best and worst exam category was 74 percentage points. Some facilities had near-zero out-of-range rates in the same categories where others exceeded 90%. [1]

Study author Rebecca Smith-Bindman, MD, of the University of California, San Francisco, said that CT scans are essential to modern medicine, but exams above the recommended threshold may carry a small radiation-related lifetime cancer risk. In her words, excellent performance is already achievable with the scanners hospitals have today. [1]

Smith-Bindman said the findings suggest each facility needs its own category-level results to know which protocols to target. She described the problem as one of measurement and feedback rather than technology. She also noted that this is the first time facilities have received automated, protocol-level feedback on radiation doses as a routine part of quality reporting. [1]

## Sources

1. [EurekAlert](https://www.eurekalert.org/news-releases/1150168)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-e3fd1883c03d98aa3fbb243e_jacr_30_7/