Related Experiment Video
Updated: Aug 1, 2026
X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging
Published on: September 11, 2011
Radiologist Professional Payments After Mitigation of CMS's Multiple-Procedure Payment Reduction Initiatives
Gelareh Sadigh1, Danny Hughes2, Wenyi Wang3
1Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Purpose:
The aim of this study was to assess the potential impact of ACR evidence-based advocacy on radiologist professional reimbursement from individual-provider CMS multiple-procedure payment reduction (MPPR) initiatives.
Methods:
CMS Physician and Other Supplier Public Use Files and 5% research-identifiable file carrier claims files from 2012 through 2014 were used to identify individual-provider MPPR-eligible services for radiologists (group practice linking unavailability in either dataset precluded quantification of different provider discounting) and then compare actual payments to Medicare Physician Fee Schedule national professional reimbursement rates to identify MPPR-discounted services. Payments attributed to MPPR-affected services and average radiologist annual MPPR discounts were calculated to estimate incremental individual radiologist payment restoration as a result of evidence-based advocacy.
Results:
Between 2012 and 2014, a mean of 803 to 836 advanced imaging services per radiologist were potentially affected by individual-provider MPPR discounting. Approximately 23% of these services were discounted by individual-provider MPPR, resulting in approximately $2,524 to $2,893 lost per radiologist per year. The MPPR rollback from 25% to 5% is thus estimated to return $55 million to $64 million to radiologists each year for the individual component of MPPR alone.
Conclusions:
Individual-provider MPPR discounting resulted, on average, in more than $2,500 in lost payments per radiologist per year. Its rollback, associated with ACR evidence-based advocacy efforts, is estimated to return well over $50 million in Medicare professional payments to radiologists each year for individual-component MPPR discounting alone.
Insights
American College of Radiology advocacy efforts helped restore over $50 million annually in Medicare payments for radiologists by reducing multiple-procedure payment reductions (MPPR). This rollback addressed significant annual payment losses per provider.
Area of Science:
- Health Economics
- Medical Policy
- Radiology Reimbursement
Background:
- The Centers for Medicare & Medicaid Services (CMS) implemented multiple-procedure payment reduction (MPPR) initiatives impacting radiologist professional reimbursement.
- Individual-provider MPPR policies led to significant financial losses for radiologists through payment discounts on advanced imaging services.
Purpose of the Study:
- To evaluate the financial impact of American College of Radiology (ACR) evidence-based advocacy on radiologist reimbursement.
- To quantify the effect of MPPR initiatives on individual radiologist payments and the restoration achieved through advocacy.
Main Methods:
- Analysis of CMS Physician and Other Supplier Public Use Files and carrier claims data from 2012-2014.
- Identification of MPPR-eligible services for radiologists and comparison of actual payments to Medicare Physician Fee Schedule rates.
- Calculation of MPPR-attributed payments and average annual discounts to estimate payment restoration.
Main Results:
- Between 2012-2014, radiologists faced annual losses of approximately $2,524 to $2,893 per provider due to MPPR discounting on advanced imaging services.
- Approximately 23% of potentially affected services were discounted under the individual-provider MPPR.
- The rollback of MPPR from 25% to 5% is estimated to return $55-$64 million annually to radiologists for the individual component.
Conclusions:
- Individual-provider MPPR discounting resulted in substantial annual payment losses for radiologists, averaging over $2,500 per provider.
- ACR's evidence-based advocacy efforts are linked to the MPPR rollback, estimated to restore over $50 million in annual Medicare professional payments to radiologists.
