Under MPPR, when more than one “always therapy” service is billed for the same patient on the same date of service, Medicare reimburses the therapy service with the highest practice expense value at the full rate, but reduces the practice expense portion of all additional therapy services by 50%. This reduction applies across therapy disciplines and can affect care provided by PT, OT, and SLP professionals when patients appropriately receive more than one therapy service on the same day.
This policy unfairly penalizes therapy providers for delivering coordinated, efficient, and patient-centered care. For many patients, particularly older adults, individuals with complex functional needs, and those requiring multiple therapy disciplines, same-day therapy is clinically appropriate and often necessary. Yet MPPR reduces reimbursement in a way that does not reflect the cost of maintaining qualified staff, clinical space, equipment, documentation, compliance, and administrative infrastructure needed to deliver high-quality rehabilitation services.
MPPR also compounds the financial strain already facing therapy providers under an unstable Medicare physician fee schedule. Continued reductions make it increasingly difficult for rehabilitation therapy providers to sustain services, invest in their workforce, and continue accepting Medicare beneficiaries.
The impact is especially harmful for patients in rural, underserved, and transportation-limited communities, where receiving all 3 disciplines on the same day may reduce travel burdens, improve adherence, and support better outcomes. Instead of supporting efficient access to coordinated rehabilitation care, MPPR penalizes providers for arranging services in a way that best meets patient needs.
NARA urges Congress to pass the RECOVER Act and repeal MPPR to protect access to essential rehabilitation services and support the providers who deliver them. We are asking rehabilitation therapy providers to reach out to your US House of Representatives Member and request that they co-sponsor this key legislative effort to repeal the MPPR policy!