CommercialReimbursementMedium impact
00.01.72, Multiple Procedure Payment Reduction (MPPR) Guidelines for Transvaginal and Transabdominal Ultrasounds
Independence Blue Cross·OB-GYN, Radiology·Claims & Billing
Effective date
Mar 2, 2026
We identified it
Jun 19, 2026
Summary
This new policy establishes Multiple Procedure Payment Reduction (MPPR) guidelines for transvaginal and transabdominal ultrasounds, effective March 2, 2026. The policy defines how payment reductions apply when these ultrasound procedures are billed together, requiring billing teams to implement new bundling or reduction rules for these imaging services.
Action Required
By February 28, 2026: Billing team must obtain the complete policy details from the source URL (https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=12&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-00-01-72) to identify specific CPT codes affected by MPPR. Update billing software to apply appropriate payment reductions when transvaginal and transabdominal ultrasounds are billed on the same claim. Train billing staff on new bundling rules and communicate MPPR requirements to ultrasound providers. Implement edits in claims processing system before the March 2, 2026 effective date. Failure to apply MPPR correctly may result in overpayment recovery or claim denials.