CMS’s decision to expand its Multiple Procedure Payment Reduction
(MPPR) to the professional component (PC) of diagnostic imaging services is
rooted in a grossly incorrect assumption, according to a letter sent to CMS
administrator Donald Berwick by the ACR late last month. The letter, intended
to comment on CMS’s proposed physician fee schedule for next year, suggested
that there are no more than 5 percent efficiencies in physician work when two
studies are furnished to the same patient by the same physician, less than ten
percent of what the expansion assumes.
CMS’s decision to expand the MPPR to the PC of diagnostic
imaging services is thought to be largely based on the results of a 2009 study
produced by the Government Accountability Office entitled “Fees Could Better
Reflect Efficiencies Achieved When Services Are Provided Together.” That study
concluded that potential efficiencies in the work component of multiple exams
might warrant a 25% reduction in reimbursement for second and subsequent exams.
The study was also cited by MedPAC as part of its 2011 recommendation to
congress to expand the MPPR.
ACR Cites New Evidence in Opposing Expansion of MPPR