Update to Multiple Procedure Payment Reduction reimbursement

Oct. 2024Important Notices

We previously communicated to both contracted physicians and facilities that UPMC Health Plan will begin applying Multiple Procedure Payment Reduction (MPPR) on certain diagnostic imaging services for Commercial, Medicare and Medicaid lines of business, with contracts based on a percentage of Medicare APC or % billed charges excluded.

There are modifications to this change, as only professional claims will be affected. This implementation will not affect facility claims. Additionally, this application will not include Medicaid line of business claims as previously noted. If you have any questions, please contact your physician account executive or call Provider Services at 1-866-918-1595.

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