Billing Beat

Multiple Procedure Reduction –Radiology effective 7/13/15

May 20, 2015

When designated multiple radiological procedures are performed in the same session, the reimbursement for the technical component of the procedure with the greatest allowable is 100% of the fee schedule/MRC or other allowed amount. The reimbursement for the technical component of the second and each subsequent imaging procedure is 50% of the fee schedule/MRC or other allowed amount. If the services are billed with a global rate, the global rate is split with 70% representing the technical component and 30% representing the professional component. In the case of global billing, the reimbursement is 65% (50% of the 70%, which represents the technical component, plus 30% for the professional component). The professional component of these fees is not subject to the multiple radiology reduction. Multiple radiology reduction applies to all places of service with the exception of inpatient hospital.

Source: https://cignaforhcp.cigna.com/secure/content/pdf/resourceLibrary/clinReimPolsModifiers/Notification/R01_Multiple_Radiology_Imaging_Reduction_Contiguous_Body_Parts.pdf

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