New reimbursement policy: Multiple Procedure Payment Reduction — Professional

Effective April 12, 2023, Anthem Blue Cross and Blue Shield combined the Multiple Diagnostic Ophthalmology Procedures — Professional and Multiple Diagnostic Cardiovascular Procedures — Professional reimbursement policies into a single reimbursement policy titled Multiple Procedure Payment Reduction — Professional. This policy allows reimbursement based on the CMS national physician fee schedule’s (NPFS) multiple procedure indicator (MPI) payment-adjustment rules. When multiple services are performed on the same date of service, during the same encounter (and are performed by the same provider or provider group), the following procedures will be subject to multiple procedure payment reductions (MPPR):

• Cardiovascular procedures
• Ophthalmology procedures

The Multiple Diagnostic Ophthalmology Procedures - Professional and Multiple Diagnostic Cardiovascular Procedures - Professional reimbursement policies will be retired.

For specific policy details, visit: reimbursement policy page at Anthem.com.