US · guidance
CMS Pub. 100-04, ch. 4, § 250.16
Multiple Procedure Payment Reduction (MPPR) on Certain
Diagnostic Imaging Procedures Rendered by Physicians
(Rev. 3578, Issued: 08-05 Effective: 01-01-17, Implementation: 01-03-17)
Diagnostic imaging procedures rendered by a physician that has reassigned their billing
rights to a Method II CAH are payable by Medicare when the procedures are eligible and
billed on type of bill 85x with revenue code (RC) 096x, 097x and/or 098x.
The MPPR on diagnostic imaging applies when multiple services are furnished by the
same physician to the same patient in the same session on the same day. Full payment is
made for each service with the highest payment under the MPFS. Effective for dates of
services on or after January 1, 2012, payment is made at 75 percent for each subsequent
service; and effective for dates of services on or after January 1, 2017, payment is made
at 95 percent for each subsequent service.
History
(Rev. 3578, Issued: 08-05 Effective: 01-01-17, Implementation: 01-03-17)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
b05f836dc8f970f4246113081f826b76ce4692ec440d30c160f9bd2624cd3a90
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