French radiologists and other medical imagers are preparing themselves for the results of a meeting on 20 May between five practitioner unions and Thomas Fatome, the director of France’s national health insurance fund (Caisse nationale d’assurance maladie, CNAM), following more than 12 months of wrangling over cuts to medical imaging, sanctioned under the most recent social security financing bill.
The meeting is to discuss the progress of the savings plan and its impact so far, which according to France’s national union of independent radiologists (Fédération nationale de médecins radiologues, FNMR) has led to 50% of imaging centers losing 10% in turnover in just five months.
The meeting on 20 May is the latest in a string of negotiations aimed at finding agreement between the medical unions and the CNAM to curb rising health costs. It will be followed by a final meeting on 10 June before the 15 June deadline to sign a corrective to a convention that so far unions have refused to sign, and which -- depending on its outcome -- may potentially trigger further action, following strikes and demonstrations at the end of 2025.
“At the last meeting in April this year, Mr. Fatome, said that everything was under control and going to plan, even if the cuts were a little higher than he had forecast. However, he is making the cuts that the government wanted and imposing a Marxist policy on radiologists’ revenue,” noted Dr. Jean-Philippe Masson, president of the FNMR.
The CNAM is aiming to cut costs in medical imaging by €300 million between 2025 and the end of 2027, these cuts being part of a larger drive to save €6 billion in health and social security costs.
In May of 2025 the proposals triggered protests across the country by unions who refused to sign the convention agreeing to them, culminating in a national strike on 10 November 2025 which impacted 80% of private radiology services, and strikes and demonstrations on 10 January 2026 by 50,000 medical professionals.
Frances Rylands-Monk
Unfairly singling out radiology
Masson believes that the cuts single out radiology unfairly for reasons other than wanting to reduce health costs.
“In June 2025, the director told us he had been asked to create a policy of standardized incomes across all medical disciplines; this is a Marxist philosophy which doesn’t take into account the investment needed in heavy state-of-the-art imaging equipment,” Masson noted.
The decision by the director of the CNAM in November 2025 to cut €300 million by the end of 2027, equates to around €120 million per year in a period of 2.5 years, Masson continued. However FNMR’s estimations suggest that this figure could reach €200 million per year, and by the end of 2027 the true figure will be cuts of €400 to €500 million.
“We calculated that turnover in private imaging between the start of November 2025 to the end of March 2026 was down €120 million already in just five months, an enormous loss due to cuts in the reimbursement for radiology and other specialties’ imaging acts. Extrapolating from this data, the final figure will be closer to €500 million in cuts by the end of 2027,” Masson noted.
A changing goalpost
He believes that the expanding cuts represent a changing goalpost that will continue to grow indefinitely to the detriment of imaging and medical care in general.
Describing in part how the cuts work, he explained that previously, radiologists were reimbursed for radiological acts such as an x-ray of the wrist 100% for an initial image and then 50% for second, third, fourth and subsequent images. Since November 2025, however, the same x-rays are reimbursed 100% for the first image, 50% for the second, and then not at all for any subsequent images after the first two.
“It’s like going to the butcher and buying two slices of meat and then getting the next slice free -- three or more for the price of two,” he said.
Dr. Jean-Philippe Masson, FNMR president
The medical imaging cuts also include a reduction of 12% in the technical fees for CT and MRI which by the end of 2027 will equate to cuts of €150 million, half of the overall €300 million targeted by the CNAM. Masson believes this is unfair as CT and MRI represent only 30% of medical imaging expenses, with the remainder of costs stemming from ultrasound and other radiological acts.
“This cut in technical fees for CT and MRI has been done on purpose as the government thinks the fees for CT and MRI are too high in France, which is stupid as even before the cuts they were among the lowest in western Europe: Now, for a CT the technical fee is around 90 euros that goes to the machine owner to pay for the investment, upkeep, the staff working on it, and overheads like electricity,” noted Masson. “Diagnostic fees are even lower. For example the fee for interpreting any CT in France is 26 euros, lower than a GP consultation fee.”
The corrective is likely to reduce cuts to ultrasound and other imaging, but Masson believes that the €300 million savings will still be in play and that nothing will change in the cuts aimed at CT and MRI.
“So far the unions have not wanted to sign any new article of the convention with the CNAM and it is unlikely they will do so on 15 June,” he said.
He pointed to an upcoming meeting, "Imaging 2026," organized by FNMR in June in Paris, with the theme being "Radiology, an asset for the country" to which Fatome is invited.
