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<meta name="DC.Title" content="Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology—Report from an Academic Medical Center" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5555" />
<meta name="DC.Date" content="2018-04-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2018 by American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The Centers for Medicare and Medicaid Services imposed a 25% professional component multiple procedure payment reduction for the professional component of advanced diagnostic imaging modalities in January 2012. In 2017, the Centers for Medicare and Medicaid Services rolled back the multiple procedure payment reduction to 5% for subsequent imaging. To evaluate the effect of this change, we analyzed 5 months of Centers for Medicare and Medicaid Services procedures at Johns Hopkins Medical Institution.

MATERIALS AND METHODS: We analyzed the procedure codes and reimbursement rate for studies performed between January 1 and May 31, 2017. Patients with Medicare insurance who had multiple diagnostic procedures in a day were selected. Per the Centers for Medicare and Medicaid Services guidelines, procedures with the highest price were considered fully reimbursed and subsequent studies were marked for differences between 25% (2013–2016) and 5% reduction (2017).

RESULTS: We included 8787 patients with 22,236 procedures (mean, 2.53 studies/day). CT, MR imaging, and ultrasound scans composed 75.9%, 21.5%, and 2.6% of all studies, with 61.2%, 54.9%, and 85.4% of the procedures of each technique subject to multiple procedure payment reduction, respectively. The projected reimbursement for these studies was $1,666,437, which translated to a $179,782 (12.1%) increase in revenue comparing 25%-versus-5% multiple procedure payment reduction rates for 5 months: $128,542 for CT, $47,802 for MR imaging, and $3439 for ultrasound. The annual overall prorated increase in revenue would be $431,476. The impact was maximal for neuroradiology.

CONCLUSIONS: With the recent favorable adjustment in multiple procedure payment reduction regulations, CT-heavy subspecialties like neuroradiology benefit the most with revenue increases. Different practice settings might experience revenue increases to a different extent, depending on the procedure and payer mix.

ACR
:   American College of Radiology
ASNR
:   American Society of Neuroradiology
CMS
:   Centers for Medicare and Medicaid Services
CPT
:   Current Procedural Terminology
MPPR
:   multiple procedure payment reduction
PC
:   professional component
TC
:   technical component
US
:   ultrasound" />
<meta name="DC.Contributor" content="B.B. Noveiry" />
<meta name="DC.Contributor" content="F.N. Varzaneh" />
<meta name="DC.Contributor" content="D.M. Yousem" />
<meta name="article:published_time" content="2018-04-01" />
<meta name="citation_title" content="Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology—Report from an Academic Medical Center" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The Centers for Medicare and Medicaid Services imposed a 25% professional component multiple procedure payment reduction for the professional component of advanced diagnostic imaging modalities in January 2012. In 2017, the Centers for Medicare and Medicaid Services rolled back the multiple procedure payment reduction to 5% for subsequent imaging. To evaluate the effect of this change, we analyzed 5 months of Centers for Medicare and Medicaid Services procedures at Johns Hopkins Medical Institution.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We analyzed the procedure codes and reimbursement rate for studies performed between January 1 and May 31, 2017. Patients with Medicare insurance who had multiple diagnostic procedures in a day were selected. Per the Centers for Medicare and Medicaid Services guidelines, procedures with the highest price were considered fully reimbursed and subsequent studies were marked for differences between 25% (2013–2016) and 5% reduction (2017).&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;We included 8787 patients with 22,236 procedures (mean, 2.53 studies/day). CT, MR imaging, and ultrasound scans composed 75.9%, 21.5%, and 2.6% of all studies, with 61.2%, 54.9%, and 85.4% of the procedures of each technique subject to multiple procedure payment reduction, respectively. The projected reimbursement for these studies was $1,666,437, which translated to a $179,782 (12.1%) increase in revenue comparing 25%-versus-5% multiple procedure payment reduction rates for 5 months: $128,542 for CT, $47,802 for MR imaging, and $3439 for ultrasound. The annual overall prorated increase in revenue would be $431,476. The impact was maximal for neuroradiology.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;With the recent favorable adjustment in multiple procedure payment reduction regulations, CT-heavy subspecialties like neuroradiology benefit the most with revenue increases. Different practice settings might experience revenue increases to a different extent, depending on the procedure and payer mix.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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MATERIALS AND METHODS: We analyzed the procedure codes and reimbursement rate for studies performed between January 1 and May 31, 2017. Patients with Medicare insurance who had multiple diagnostic procedures in a day were selected. Per the Centers for Medicare and Medicaid Services guidelines, procedures with the highest price were considered fully reimbursed and subsequent studies were marked for differences between 25% (2013–2016) and 5% reduction (2017).

RESULTS: We included 8787 patients with 22,236 procedures (mean, 2.53 studies/day). CT, MR imaging, and ultrasound scans composed 75.9%, 21.5%, and 2.6% of all studies, with 61.2%, 54.9%, and 85.4% of the procedures of each technique subject to multiple procedure payment reduction, respectively. The projected reimbursement for these studies was $1,666,437, which translated to a $179,782 (12.1%) increase in revenue comparing 25%-versus-5% multiple procedure payment reduction rates for 5 months: $128,542 for CT, $47,802 for MR imaging, and $3439 for ultrasound. The annual overall prorated increase in revenue would be $431,476. The impact was maximal for neuroradiology.

CONCLUSIONS: With the recent favorable adjustment in multiple procedure payment reduction regulations, CT-heavy subspecialties like neuroradiology benefit the most with revenue increases. Different practice settings might experience revenue increases to a different extent, depending on the procedure and payer mix.

ACR
:   American College of Radiology
ASNR
:   American Society of Neuroradiology
CMS
:   Centers for Medicare and Medicaid Services
CPT
:   Current Procedural Terminology
MPPR
:   multiple procedure payment reduction
PC
:   professional component
TC
:   technical component
US
:   ultrasound" />
<meta name="og-title" property="og:title" content="Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology—Report from an Academic Medical Center" />
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<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The Centers for Medicare and Medicaid Services imposed a 25% professional component multiple procedure payment reduction for the professional component of advanced diagnostic imaging modalities in January 2012. In 2017, the Centers for Medicare and Medicaid Services rolled back the multiple procedure payment reduction to 5% for subsequent imaging. To evaluate the effect of this change, we analyzed 5 months of Centers for Medicare and Medicaid Services procedures at Johns Hopkins Medical Institution.

MATERIALS AND METHODS: We analyzed the procedure codes and reimbursement rate for studies performed between January 1 and May 31, 2017. Patients with Medicare insurance who had multiple diagnostic procedures in a day were selected. Per the Centers for Medicare and Medicaid Services guidelines, procedures with the highest price were considered fully reimbursed and subsequent studies were marked for differences between 25% (2013–2016) and 5% reduction (2017).

RESULTS: We included 8787 patients with 22,236 procedures (mean, 2.53 studies/day). CT, MR imaging, and ultrasound scans composed 75.9%, 21.5%, and 2.6% of all studies, with 61.2%, 54.9%, and 85.4% of the procedures of each technique subject to multiple procedure payment reduction, respectively. The projected reimbursement for these studies was $1,666,437, which translated to a $179,782 (12.1%) increase in revenue comparing 25%-versus-5% multiple procedure payment reduction rates for 5 months: $128,542 for CT, $47,802 for MR imaging, and $3439 for ultrasound. The annual overall prorated increase in revenue would be $431,476. The impact was maximal for neuroradiology.

CONCLUSIONS: With the recent favorable adjustment in multiple procedure payment reduction regulations, CT-heavy subspecialties like neuroradiology benefit the most with revenue increases. Different practice settings might experience revenue increases to a different extent, depending on the procedure and payer mix.

ACR
:   American College of Radiology
ASNR
:   American Society of Neuroradiology
CMS
:   Centers for Medicare and Medicaid Services
CPT
:   Current Procedural Terminology
MPPR
:   multiple procedure payment reduction
PC
:   professional component
TC
:   technical component
US
:   ultrasound" />
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      <h1 class="highwire-cite-title" id="page-title">Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology—Report from an Academic Medical Center</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">B.B. Noveiry</span>, <span class="highwire-citation-author" data-delta="1">F.N. Varzaneh</span> and <span class="highwire-citation-author" data-delta="2">D.M. Yousem</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">April 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">612-617; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5555 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-60145--6132057510" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">B.B. Noveiry </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Medicine (B.B.N.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.B.%2BNoveiry%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Noveiry%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.B.%2BNoveiry%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6281-3811" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B.B. Noveiry</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">F.N. Varzaneh </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (F.N.V.), Division of Body MRI, Johns Hopkins University, Baltimore, Maryland</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.N.%2BVarzaneh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Varzaneh%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.N.%2BVarzaneh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6952-445X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.N. Varzaneh</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">D.M. Yousem </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (D.M.Y.), Division of Neuroradiology, Johns Hopkins Medical Institution, Baltimore, Maryland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.M.%2BYousem%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yousem%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.M.%2BYousem%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1222-6643" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.M. Yousem</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-39.4.612.1" data-doi="10.1016/j.jacr.2012.12.017"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Rehani</span>  <span class="cit-name-given-names">B</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Basu</span>  <span class="cit-name-given-names">P</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Ellenbogen</span>  <span class="cit-name-given-names">PH</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">The threat to radiologists from the multiple-procedure payment reduction</span>. <abbr class="cit-jnl-abbrev">J Am Coll Radiol</abbr> <span class="cit-pub-date">2013</span>;<span class="cit-vol">10</span>:<span class="cit-fpage">237</span>–<span class="cit-lpage">38</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.jacr.2012.12.017</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>23545081</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jacr.2012.12.017&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=23545081&amp;link_type=MED&amp;atom=%2Fajnr%2F39%2F4%2F612.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a><div class="cit ref-cit ref-web" id="cit-39.4.612.2"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Hackney</span>  <span class="cit-name-given-names">DB</span></span></li></ol><cite>. <span class="cit-article-title">The Centers for Medicare &amp; Medicaid Services (CMS) issues new proposals</span>. <span class="cit-pub-date">2011</span>. <span class="cit-comment"><a href="https://www.asnr.org/the-center-for-medicare-medicaid-services-cms-issues-new-proposals/">https://www.asnr.org/the-center-for-medicare-medicaid-services-cms-issues-new-proposals/</a>. Accessed November 20, 2017</span>. </cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a><div class="cit ref-cit ref-web" id="cit-39.4.612.3"><div class="cit-metadata"><cite><span class="cit-auth cit-collab">ASNR</span>. <span class="cit-article-title">Procedure payment reduction (MPPR) policy to the professional component of advanced imaging service</span>. <span class="cit-pub-date">2011</span>. <span class="cit-comment"><a href="https://www.asnr.org/procedure-payment-reduction-mppr-policy-to-the-professional-component-of-advanced-imaging-service/">https://www.asnr.org/procedure-payment-reduction-mppr-policy-to-the-professional-component-of-advanced-imaging-service/</a>. . November 20, 2017</span>.</cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a><div class="cit ref-cit ref-web" id="cit-39.4.612.4"><div class="cit-metadata"><cite><span class="cit-auth cit-collab">ACR</span>. <span class="cit-article-title">Professional Component Multiple Procedure Payment Reduction. Oppose Further Application of a Multiple Procedure Payment Reduction to the Professional Component of Diagnostic Imaging Services</span>. <span class="cit-source">Advocacy, Legislative Issue</span>; <span class="cit-pub-date">2016</span>. <span class="cit-comment"><a href="https://www.acr.org/Advocacy-and-Economics/Legislative-Issues/MPPR">https://www.acr.org/Advocacy-and-Economics/Legislative-Issues/MPPR</a>. Accessed June 11, 2017</span>. </cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">5.</span><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5. in text" id="ref-5">↵</a><div class="cit ref-cit ref-journal" id="cit-39.4.612.5" data-doi="10.1016/j.jacr.2015.06.043"><div class="cit-metadata"><ol class="cit-auth-list"><li>
</li><li><span class="cit-auth"><span class="cit-name-surname">Chiao</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Monceaux</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Krishnaraj</span>  <span class="cit-name-given-names">A</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Impact of the professional component MPPR policy on interdivisional finances in an academic radiology department</span>. <abbr class="cit-jnl-abbrev">J Am Coll Radiol</abbr> <span class="cit-pub-date">2016</span>;<span class="cit-vol">13</span>:<span class="cit-fpage">274</span>-<span class="cit-lpage">78</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.jacr.2015.06.043</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>26507821</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jacr.2015.06.043&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=26507821&amp;link_type=MED&amp;atom=%2Fajnr%2F39%2F4%2F612.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a><div class="cit ref-cit ref-web" id="cit-39.4.612.6"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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</li><li><span class="cit-auth"><span class="cit-name-surname">Duszak</span>  <span class="cit-name-given-names">R</span>  <span class="cit-name-suffix">Jr</span>.</span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Silva</span>  <span class="cit-name-given-names">E</span>  <span class="cit-name-suffix">3rd</span>.</span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kim</span>  <span class="cit-name-given-names">AJ</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Professional efficiencies for diagnostic imaging services rendered by different physicians: analysis of recent Medicare multiple procedure payment reduction policy</span>. <abbr class="cit-jnl-abbrev">J Am Coll Radiol</abbr> <span class="cit-pub-date">2013</span>;<span class="cit-vol">10</span>:<span class="cit-fpage">682</span>–<span class="cit-lpage">88</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.jacr.2013.02.019</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>23575316</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jacr.2013.02.019&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=23575316&amp;link_type=MED&amp;atom=%2Fajnr%2F39%2F4%2F612.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">21.</span><a class="rev-xref-ref" href="#xref-ref-21-1" title="View reference 21. in text" id="ref-21">↵</a><div class="cit ref-cit ref-web" id="cit-39.4.612.21"><div class="cit-metadata"><cite><span class="cit-auth cit-collab">ACR</span>. <span class="cit-article-title">Frequently Asked Questions on the PC MPPR and Digital Radiography policy within H.R. 2029, the Consolidated Appropriations Act of 2016</span>. <span class="cit-pub-date">2016</span>. <span class="cit-comment"><a href="https://www.acr.org/Advocacy-and-Economics/Legislative-Issues/MPPR/FAQ">https://www.acr.org/Advocacy-and-Economics/Legislative-Issues/MPPR/FAQ</a>. Accessed August 24, 2017</span>. </cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">22.</span><a class="rev-xref-ref" href="#xref-ref-22-1" title="View reference 22. in text" id="ref-22">↵</a><div class="cit ref-cit ref-web" id="cit-39.4.612.22"><div class="cit-metadata"><cite><span class="cit-auth cit-collab">CMS Department of Health &amp; Human Services</span>. <span class="cit-article-title">Multiple Procedure Payment Reduction (MPPR) on the Professional Component (PC) of Certain Diagnostic Imaging Procedures</span>. <span class="cit-pub-date">2016</span>. <span class="cit-comment"><a href="https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3578CP.pdf">https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3578CP.pdf</a>. Accessed August 24, 2017</span>. </cite></div><div class="cit-extra"></div></div></li></ol></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 39</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 4 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Apr 2018 </div></div>
      
      
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      <div class="highwire-cite-title">Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology—Report from an Academic Medical Center</div>  
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      <div class="highwire-cite-title">Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology—Report from an Academic Medical Center</div>  
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