Medicare AdvantageReimbursementHigh impact
MA00.057, Multiple Procedure Payment Reduction (MPPR) Guidelines for Transvaginal and Transabdominal Ultrasounds
Independence Blue Cross·OB-GYN, Radiology, Diagnostic Imaging·Claims & Billing
Effective date
Mar 2, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage plans are implementing new Multiple Procedure Payment Reduction (MPPR) guidelines specifically for transvaginal and transabdominal ultrasounds. This means when multiple ultrasound procedures are performed on the same day, reimbursement will be reduced for subsequent procedures according to the new MPPR rules.
Action Required
By March 2, 2026: Billing team must update payment expectations and cash flow projections for Medicare Advantage ultrasound procedures. Review current billing practices for same-day multiple ultrasounds and adjust financial estimates to account for MPPR reductions on secondary procedures. Update staff training on explaining potential payment reductions to patients when multiple ultrasounds are scheduled same-day.