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 19, 2019 / Review
Jan 7, 2021 / Members Only
Mar 19, 2021 / Resource
Additional Multiple Procedure Payment Reduction and the Physician Fee Schedule Content
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Get updates on the proposed Medicare physician fee schedule, what we’re doing to #FightTheCut, and how you can help.
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Jul 22, 2021 / Members Only
July 21, 2021: Topics discussed: 2022 Home Health and Fee Schedule Rules, Commercial Payer Update, Telehealth, NCCI edits, Utilization Management, Service Reviews, Payer Resources.
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Consistent with an APTA report, the study says fee schedule payment for physical therapy dropped by 34% during the pandemic's first wave.
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Expanded CMS resources include more examples. APTA revised its guide and offers additional insight.
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PTs are facing Medicare payment cuts. But what does that really mean?