Medicare AdvantageReimbursementHigh impact
[New York] Reimbursement policy update: Multiple Radiology Payment Reduction
Anthem BCBS·NY · Radiology·Claims & Billing
Effective date
Apr 1, 2026
We identified it
May 8, 2026
Summary
Effective April 1, 2026, Anthem Medicare Advantage plans in New York will expand their Multiple Radiology Payment Reduction policy to include CT scan services. When multiple diagnostic imaging procedures with CMS NPFS multiple procedure indicator (MPI) of 4 are performed by the same provider on the same date of service, only the highest-allowance component will be reimbursed at 100%; additional procedures will receive reduced payment.
Action Required
Before April 1, 2026: Billing team must review current radiology bundling logic in billing software to identify all CT scan services (MPI indicator 4) that may be affected by multiple procedure reductions. Update billing system rules to automatically identify when multiple diagnostic imaging procedures occur on the same date of service by the same provider group, and ensure secondary procedures are reimbursed at the reduced rate with the highest-allowance component paid at 100%. Providers should be notified of the policy change to manage clinical workflow expectations. Review historical claims for similar patterns to anticipate revenue impact. Failure to implement these changes will result in incorrect claim submissions and potential payment denials or recoupments by Anthem.