Magnetic Resonance Imaging Policy Update

Effective for dates of service on or after April 1, 2012, Magnetic Resonance Imaging (MRI) reimbursement policy will be updated. When more than one scan is performed during the same session, the provider must document the time of the initial scan and CPT code in Box 19 of the claim. Reimbursement for multiple MRI services, same session, on the same date of service and provider will be reimbursed as follows; the professional component (modifier 26) is 100 percent for the first, second and subsequent MRIs and the technical component (modifier TC) is 100 percent for the first MRI and 50 percent for the second and subsequent MRIs. When more than one scan is performed during different sessions the provider must document the time of the initial scan and CPT code in Box 19 of the claim. Reimbursement for multiple MRI sessions is at 100 percent for both the Technical Component (modifier TC) and the professional component (modifier 26) when there is documentation of the times of services and CPT code for each scan performed. Source: General Medicine | March 2012 | Bulletin 453