Part Four: MPPR
MPPR stands for Multiple Procedure Payment Reduction. This policy became effective on January 1st 2011. CMS believed that providers of services under Part B were being paid more than they should due to the methodology of valuing the CPT codes. This new policy is supposed to reduce payment for outpatient physical therapy services by 7-9% in 2011. The MPPR policy provides for the first unit of the Always Therapy code with the highest Practice Expense (PE) to be paid at 100% of the Fee Screen Rate. All subsequent units/codes across all disciplines require a 20% reduction in the PE component of the Fee Screen Rate. This policy is provider specific, not discipline or session specific. This means that for institutional providers that provide more than one discipline per day will have all but the highest PE reduced.
With this change, how do we “counteract” the adjustments? We’ve had to go on “business as usual,” or do we? We are always looking to improve the quality of care we provide to our residents and establish programs that insure the follow through with nursing staff when therapy is concluded. This final change was just a friendly reminder that we need to continue to pursue this goal. If we are effectively meeting the needs of all of our patients while they are on caseload, and developing effective programs to insure that nursing staff is carrying out our recommendations, and we are monitoring the progression of residents in these programs, then we will only be minimally affected by this last change to Medicare.
What’s next? MDS 4.0? RUGs V? Med B Cap Appealed? More changes to the MPPR? Change in how to bill Group Therapy? Whatever the change, we as therapists and therapy companies, will find a way to adjust, adapt, educate, and survive, in order to provide the best possible care to our patients, despite the payer source or description of our services.