The multiple procedure payment reduction (MPPR) policy is scheduled to increase to 50% on April 1, 2013. APTA estimates the application of a 50% MPPR policy will reduce payments by approximately 6-7% in aggregate for outpatient therapy services. This reduction will be partially offset by a 4% increase in practice expense that resulted from the Centers for Medicare and Medicaid Services’ use of new survey data of practice expenses conducted by APTA. The impact of the MPPR reduction on individual practices and facilities will vary depending on the CPT codes billed and the typical duration of the therapy sessions.
For those of you that belong to APTA, APTA has published a MPPR calculator since the inception of MPPR on January 1, 2011. The calculator is extremely helpful in determining the correct amount that is being applied to the therapy cap threshold since it takes into account the MPPR reduction. If you are an APTA member, you can access the calculator…
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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.