Part B Insider (Multispecialty) Coding Alert

Published on Fri Apr 27, 2012 PDF

Groups won't be subject to the reduction, CMS clarifies.

CMS no longer plans to apply the Multiple Procedure Payment Reduction (MPPR) professional fee cut to multiple providers within the same group practice.

Background: As reported in the Insider vol. 12, no. 40, "CMS announced that in 2012, it will not only continue to slash the technical component of subsequent radiological procedures by 50 percent, but will also begin to cut the professional component by 25 percent." Initially, CMS had said the MPPR would apply to providers within the same group practice, as well.

However, a newly-revised MLN Matters (MM7442) article clears that up, noting that CMS has reversed that decision. "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," the article notes. "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."

To read the complete article, visit http://cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM7442.pdf.