§ 9789.15.6 Diagnostic Cardiovascular Procedures - Multiple Procedure Reduction
Summary
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)
§ 9789.15.6 Diagnostic Cardiovascular Procedures - Multiple Procedure Reduction
Division of Workers’ Compensation Websites
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