Frequently Asked Questions
§ 9789.15.6 Diagnostic Cardiovascular Procedures - Multiple Procedure Reduction
Under certain circumstances, the Physician Fee Schedule reduces some reimbursements when Multiple Procedures are provided on the same day. These reductions are known as MPPRs.
Per section 9789.15.6, the MPPR on cardiovascular procedures only applies when multiple services are performed on the same day.
The MPPR only applies to:
- Technical component (TC) services
- The TC of global services
The MPPR does NOT apply to Professional Component services.
When the Cardiovascular MPPR is applied:
- Full payment is made for the TC service with the highest payment.
- Payment is made at 75% for subsequent TC services furnished by the same physician on the same day.
California Code of Regulations (CCR)
Division of Workers’ Compensation Websites
Technology is your friend when it comes to calculating correct fee schedule reimbursements. DaisyBill’s OMFS Calculator makes determining accurate reimbursements quick and hassle-free for current AND past dates of service.
Sign up for a free trial of the DaisyBill OMFS Calculator and instantly start billing easier.
Was this article helpful?
DaisyBill is a trusted authority on workers’ comp billing. Thousands of work comp professionals attend our webinars and state agencies and professional organizations turn to us for our expertise. We created this blog to help everyone involved in workers’ compensation; sharing news, tips, and data of interest to the community.
Drop us a line with any news you would like us to share or any issue that concerns you.