MPPR professional component bites the dust for group practices

The Centers for Medicare & Medicaid Services (CMS) has informed the American College of Radiology (ACR) that “operational limitations” will prevent them from applying the imaging professional component Multiple Procedure Payment Reduction (MPPR) to group practices beginning Jan. 1, 2012. Therefore, CMS will not apply the professional component MPPR for imaging services performed by separate physicians in the same group practice for 2012.

This decision will affect both office and hospital practices, according to the college.

Application of a 25 percent MPPR to the professional component of diagnostic imaging services performed by the same physician, to the same patient, during the same session remains the same.

However, the ACR said it will continue its legislative efforts to block the entire professional component MPPR through enactment of H.R. 3269, the Diagnostic Imaging Services Protection Act, in the second session of the 112th Congress. There are now 150 co-sponsors for the bill, which would prohibit any multiple procedure payment reduction to the professional component of CT, MRI and ultrasound exams received by the same patient, on the same day, in the same setting in 2012.

“I am proud of the tremendous effort exerted by more than 7,000 ACR members to contact CMS and explain the flaws in its original ruling. I’m also very gratified and encouraged by the grassroots efforts of our members in gaining support from 150 members of Congress for H.R 3269,” John A. Patti, MD, chairman of the ACR board of chancellors, said in a statement.

“While this bill [H.R. 3269] did not appear in the final 2011 healthcare legislation, it is still alive and gaining more support for the next session,” said Patti.