Under the MPPR, when therapists bill more than one “always therapy” service, identified by a Current Procedural Terminology (CPT code) on the same day for the same patient, all therapy services beyond the first service provided are subject to a reduction in the practice expense portion of that code.  Under this policy, the therapy service with the highest practice expense value is reimbursed at its full value, but the practice expense values for all subsequent therapy services, provided by all therapy providers, are reduced by 50%.

This drastic reduction has made it increasingly difficult for therapy providers to maintain their practice, and MPPR, combined with the unstable Medicare provider reimbursement system, results in providers being forced to limit the number of Medicare patients they can treat. 

MPPR penalizes providers when scheduling multiple therapies on the same date which disproportionately affects beneficiaries in rural and underserved communities where transportation issues may require therapy services to be delivered on the same day to reduce the need for repeat visits to the clinic.