Multiple Procedure Payment Reduction (MPPR) for Selected Therapy Services
Section 3134 of the Affordable Care Act (ACA) added section
1848(c)(2)(K) of the Social Security Act which specifies that the Secretary shall identify potentially
misvalued codes by examining multiple codes that are frequently billed in conjunction with furnishing a
single service. As a step in implementing this provision, Medicare is applying a new multiple procedure
payment reduction (MPPR) to the practice expense (PE) payment of select therapy services paid under the
physician fee schedule. The reduction will be similar to that currently applied to multiple surgical
procedures and to diagnostic imaging procedures. This policy is discussed in the CY 2011 physician fee
schedule proposed rule published on July 13, 2010. This advance notice is provided so contractors can
begin making the necessary systems changes for the policy to go in effect January 1, 2011.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 21, 2010
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