In response to a troublesome provision included in the fiscal cliff package passed by Congress on Tuesday, APTA is advising members to monitor APTA's website and the Legislative Action Center specifically for upcoming action alerts regarding efforts to avert the increased multiple procedure payment reduction (MPPR) included in the American Taxpayer Relief Act of 2012 (HR8).

Set to be implemented on April 1, the provision applies the MPPR to therapy services at 50%, up from 20% for office settings and 25% for facility settings. APTA estimates the application of a 50% MPPR policy will reduce payments by approximately 6%-7%. This reduction will be partially offset by a 4% increase that resulted from the Centers for Medicare and Medicaid Services' (CMS) use of new survey data of practice expenses conducted by APTA. Coupled together, APTA expects the net overall decrease for outpatient therapy services to be between 2%-3%, a lower cut than expected. Nevertheless, APTA will advocate to fix this flawed policy. The association soon will call on APTA members to make their voices heard on Capitol Hill.

The increase to a 50% MPPR was recently endorsed by the Medicare Payment Advisory Commission (MedPAC). Despite months of aggressive lobbying efforts to reject the provision, Congress ultimately included this and a number of other spending cuts in the fiscal cliff package to offset other health care related provisions, including the prevention of the 26.5% fee schedule cut and the extension of the therapy cap exceptions process.

Once policy options are assessed, APTA will issue additional alerts to PTeam. If you're not a member of PTeam, sign up today to receive the alerts. In the meantime, APTA members are encouraged to learn more about this and other important provisions included in the legislation through the resources provided on APTA's 2013 Medicare Changes: January 2013 webpage at www.apta.org/Payment/Medicare/2013/Changes/. These resources include a statement by APTA's president on HR8, a congressional summary, a 2013 Medicare therapy cap FAQ, and a 2013 Physician Fee Schedule and MPPR FAQ.

Additionally, APTA has updated the MPPR calculator to help association members determine their reimbursement for services based on the MPPR only.