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.
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