The Centers for Medicare and Medicaid Services (CMS) implemented the Multiple Procedure Payment Reduction (MPPR) policy in 2011 to outpatient therapy services provided to Medicare beneficiaries seen by one or more disciplines on the same day by the same private practice or non-private practice setting (i.e. same group NPI number or Tax ID number). I am often asked how the MPPR is applied and to what CPT codes does the MPPR apply to. I will answer those 2 questions below and provide you with a reference document from CMS detailing which CPT codes the MPPR does apply to when billed to Medicare beneficiaries receiving outpatient therapy services.
CMS applied the MPPR to the
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does this apply to outpatient departments in Critical Access Hospitals? Thanks.
No since critical access hospitals are not paid under the Medicare Physician Fee Schedule.