Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Imaging Procedures

Medicare is expanding the Multiple Procedure Payment Reduction (MPPR) to the Professional Component (PC) in addition to the Technical Component (TC) of certain diagnostic imaging procedures. Full payment is made for each PC and TC service with the highest payment under the Medicare Physician Fee Schedule (MPFS). Payment is made at 75 percent for subsequent PC services furnished by the same physician to the same patient in the same session on the same day. Payment is made at 50 percent for subsequent TC services furnished by the same physician to the same patient in the same session on the same day. Due to operational considerations, at this time, CMS is not applying the imaging MPPR to group practices when different physicians in a group see the same patient on the same day. However, if the same physician within a group practice sees the same patient in the same session on the same day, the imaging MPPR will apply as of January 1, 2012.