The MPPR policy implements a 50% payment reduction to the practice expense value of certain CPT codes deemed "always therapy services."
The multiple procedure payment reduction policy implements a 50% payment reduction to the practice expense value of certain CPT codes deemed "always therapy services." The reduction is applicable to physicians and physical therapists in private practice, CORFs, SNFs (Part B), home health (Part B), outpatient hospitals, and rehabilitation agencies. For the second and each subsequent code, the practice expense value will be reduced.
Because clinicians who deliver therapy services typically deliver a variety of services as represented by the CPT codes, there are numerous potential code combinations that, when executed, determine the total reimbursement for services in a given day.
Nov 3, 2022 / Article
Payment is the focus of this installment: Cuts, therapy thresholds, updated calculations that could be good for PTs, and more.
Nov 19, 2019 / Review
CMS finalizes a policy for determining when services are delivered "in part" by a PTA.
Jan 13, 2023 / Members Only
APTA's outpatient therapy fee schedule spreadsheet helps you determine your payment for services under Medicare.
Mar 19, 2021 / Resource
Use this guide to help you identify when you must apply the CQ modifier, which we updated in March 2021 to reflect new details from CMS.
Additional Multiple Procedure Payment Reduction and the Physician Fee Schedule Content
Jan 17, 2023 / News
The updated member benefit helps you see how CMS changes to the fee schedule, coding, and other issues will affect your practice.
Nov 8, 2022 / Article
In our final installment: MIPS, quality measures, MIPS Value Pathways, and more.
Jan 12, 2022 / News
Get a handle on how CMS changes to the fee schedule, coding, and other issues will affect your practice.
Dec 1, 2021 / Members Only
Topics discussed: Medicare Physician Fee Schedule, Vaccine Mandates, Commercial Payer Updates
Nov 23, 2021 /
As Congress attends to business in the last days before recess for the year, there are several important issues on the table, including a bill to address the fee schedule cuts, and legislation aimed at the PTA differential.
Nov 3, 2021 / Review
Despite a few bright spots, the final rule mostly follows the proposed version, making Capitol Hill the only remaining hope for relief.
Aug 25, 2021 /
Get updates on the proposed Medicare physician fee schedule, what we’re doing to #FightTheCut, and how you can help.
Aug 20, 2021 / Article
What you need to know about the cuts' origins, the system that created them, and the ways APTA has been advocating for the profession.
Aug 2, 2021 / News
A recent letter to House and Senate leaders is part of a larger advocacy push to avoid a potential crisis in patient access to care.
Jul 22, 2021 /
The proposed 2022 Medicare fee schedule is here, and as expected, cuts and the PTA differential are moving forward.