Reimbursement Policy Update: Multiple Radiology Payment Reduction

Effective December 10, 2024, the Multiple Radiology Payment Reduction reimbursement policy no longer applies to facility providers. To ensure appropriate reimbursement, these providers should follow the state Medicaid facility pricing methodology for multiple diagnostic imaging procedures.

Professional providers continue to be subject to a multiple procedure payment reduction when services are identified by a CMS National Physician Fee Schedule (NPFS) multiple procedure indicator (MPI) of 4. This applies when such services are performed by the same physician or healthcare professional, using the same National Provider Identifier, on the same date and during the same patient encounter.

For additional information, please review the Multiple Radiology Payment Reduction reimbursement policy at https://providers.anthem.com/ohio-provider/claims/reimbursement-policies.