A coalition of industry organizations, which tried last year to convince CMS not to apply the MPPR policy to therapy services, wrote to CMS Administrator Dr.
In that submission, Morton called on CMS to apply the 20% MPPR as required by the Physician Payment and Therapy Relief Act of 2010.
Recommendation: To ensure that savings are realized from the implementation of an MPPR or other policies that reflect efficiencies occurring when services are furnished together, Congress may wish to consider exempting these savings from budget neutrality.
These efforts could include (1) systematically reviewing services commonly furnished together and implementing an MPPR to capture efficiencies in both physician work and practice expenses, where appropriate, for these services; (2) focusing on service pairs that have the most impact on Medicare spending; and (3) monitoring the provision of services affected by any new policies it implements to ensure that physicians do not change their behavior in response to these policies.
It can also determine the accuracy of certain payer payment policies, such as the MPPR
or Contiguous Body Part.
CMS has also finalized the expansion of Multiple Procedure Payment Reduction (MPPR
), and this clearly will have an impact on reimbursement.
However, starting in 2013, the professional component (PC) for multiple procedures payment reduction (MPPR
), which currently applies to one radiologist interpreting multiple studies, would apply to 2 different radiologists interpreting multiple anatomical regions (say a chest CT, and abdomen/pelvic CT) on the same patient.
(1) In essence, this legislation applies a multiple procedure payment reduction (MPPR) to the professional component of advanced diagnostic imaging services administered to the same patient, by the same physician, during the same session.
It appears that the CMS decision to apply a MPPR to the professional component of diagnostic imaging services is rooted in the incorrect assumption that there are considerable efficiencies of scale when radiologists interpret successive imaging studies during a single patient visit.