CommercialReimbursementMedium impact
00.01.60j, Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Services
Independence Blue Cross·Diagnostic Imaging, Radiology·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
A Multiple Procedure Payment Reduction (MPPR) policy will be implemented on certain diagnostic services for commercial plans, effective October 1, 2025. This means when multiple diagnostic procedures are performed on the same day, reimbursement for secondary procedures will be reduced according to MPPR rules.
Action Required
Before October 1, 2025: Billing team must review and update billing software to apply MPPR reductions for multiple diagnostic procedures performed on the same day for commercial plans. Update fee schedules to reflect reduced reimbursement rates for secondary diagnostic procedures. Train billing staff on MPPR calculation rules to ensure accurate payment expectations.