Billing Beat

MPPR on the PC of certain diagnostic imaging procedures

December 20, 2016

As required by Medicare law CMS revised the Multiple Procedure Payment Reduction (MPPR) of the Professional Component (PC) of the second and subsequent procedures from 25 percent to 5 percent of the physician fee schedule amount. The MPPR on the technical component (TC) of imaging remains at 50 percent. CMS currently makes full payment for the PC of the highest priced procedure and payment at 75 percent for the PC of each additional procedure, when furnished by the same physician (or physician in the same group practice) to the same patient, in the same session on the same day.

Source: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R3676CP.pdf

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