The implementation date of the change will be July 6, according to the transmittal.
According to CMS, “the reduction applies to TC only services, and the TC portion of global services, for the procedures with a multiple surgery value of ‘4’ in the Medicare Fee Schedule database. The MPPR does not apply to the professional component (PC) or to the PC portion of global services.”
The transmittal also provides the following guidance:
“The reduction applies only to more than one procedure performed in a single imaging session on contiguous body parts, i.e., within a family of codes, not across families. For example, the reduction would not apply to an MRI of the brain (CPT 70552) in code family 5 (MRI/MRA Head/Brain/Neck), when performed during the same session, on the same day, as an MRI of the neck and spine (CPT 72142) in code family 6 (MRI/MRA Spine).”
CMS will continue its policy of paying fully for the highest-priced procedure, according to the transmittal.
Read CMS Transmittal 694 (pdf).
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