Reimbursement Policy Update: Multiple Radiology Payment Reduction (Policy 12-002)
There is a change regarding reimbursement for diagnostic imaging.
Currently, the global, professional component and technical component of diagnostic imaging procedures are reimbursed at 100% of the contracted/negotiated rate for each professional component and technical component service with the highest payment. Reimbursement of subsequent services is based on:
- 95% of the professional component.
- 60% of the technical component.
However, effective October 1, 2019, Empire BlueCross BlueShield HealthPlus will reimburse for diagnostic imaging procedures based on the following:
- 100% of the fee schedule or contracted/negotiated rate for the highest valued procedure
- 60% for the second and additional services
July 2019 Empire Provider News