Reimbursement Policy Update: Multiple Diagnostic Imaging (Facility)

Anthem will apply multiple imaging reimbursement rules to the technical component of diagnostic imaging procedures for dates of service on and after November 1, 2020. These rules apply across diagnostic imaging families, and modalities of radiology procedures and are not limited to contiguous body areas. Multiple imaging reimbursement rules are applied to the maximum allowance for the Technical Component (TC) of the following diagnostic imaging procedures rendered on the same date of service and eligible for reimbursement: Ultrasound, Computed Tomography (CT), Computed Tomographic Angiography (CTA), Magnetic Resonance Imaging (MRI), and Magnetic Resonance Angiography (MRA).

 

When two or more imaging procedures are performed in the same facility on the same patient on the same date of service, reimbursement is:

• 100% of the highest facility allowance for the first imaging procedure for the date of service.
• 50% of the facility allowance for each subsequent imaging procedure for that date of service.

For more information about this policy, visit our Reimbursement Policy page at anthem.com/provider.

 

583-0820-PN-GA