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CarePoint Therapy Management Blog

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Med B Revenue to Decline from Change in MPPR Practice Expense

  
  
  

Practice Expense Component - MPPR - PEA Contract Therapy Client In Ohio Inquired“Is the Practice Expense (PE) discount factor of the Multiple Procedure Payment Reduction (MPPR) increasing from 25% to 50% on April 1, 2013?”

Our ResponseYes, The American Taxpayer Relief Act of 2012 made it a law as of December 31, 2012.

SEC.633 TREATMENT OF MULTIPLE SERVICE PAYMENT POLICIES FOR THERAPY SERVICES; (a) SERVICES FURNISHED BY PHYSICIANS AND CERTAIN OTHER PROVIDERS – Section 1848(b) (7) of the Social Security Act (42 USC 1395w-4(b) (7)) is amended as follows –

  • By striking “2011” and inserting “2011 and before April 1, 2013,” and

  • By adding at the end the following new sentence, “In the case of such services furnished on or after April 1, 2013, and for which payment is made under such fee schedules, instead of the 25 percent MPPR specified in such final rule, the reduction percentage shall be 50 percent.” 

There was a 20% MPPR for Private Practice but as of April 1, that will increase to 50% as well.

Medicare Part B Revenue Will Decline Sharply From This Change …

A client with 60 facilities in 5 states had $2.4 million of Medicare Part B revenue through February 28, 2013.  Med B revenue may decline $1.1 million in 2013 from this change.  For example, their MPPR adjustment was $177,000 or 7.5% when the PE discount factor was 25%.  The MPPR adjustment increased to $355,000 or 15.0% when the PE discount factor was increased to 50%.

Planning & Scheduling Strategies & Recommendations …

Visit our Blog 5 Tips to Minimize the Multiple Procedure Payment Reduction.  Simple planning and scheduling strategies can be implemented to minimize your MPPR adjustment and maintain Medicare Part B revenue to the extent possible.

CarePoint therapy management software clients should change the PE discount factor to 50% in the Set Up module, Organization menu, User parameters option in April 2013 after contract therapy billing invoices for March have been processed.  See the screen shot below …

Practice Expense Component - MPPR

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