<p>The United Physical Therapy Association has submitted a petition asking the Centers for Medicare &amp; Medicaid Services to re-examine how the Multiple Procedure Payment Reduction (MPPR) is applied to outpatient therapy services. The current policy assumes efficiencies that often do not exist in real clinical care and is placing strain on therapy providers serving Medicare patients. We respectfully ask for your support by sending a letter to CMS encouraging a re-evaluation of this policy to help protect patient access to rehabilitation services.&nbsp;</p>


Protect Patient Access: Support the MPPR Petition to CMS

I am writing to ask for your support of a petition submitted by the United Physical Therapy Association (UPTA) requesting that the Centers for Medicare & Medicaid Services (CMS) re-examine how the Multiple Procedure Payment Reduction (MPPR) is applied to outpatient therapy services.

Louisiana Attorney General Liz Murrill has submitted a letter supporting the United Physical Therapy Association’s Petition for Rulemaking requesting that the Centers for Medicare & Medicaid Services (CMS) refine how the Multiple Procedure Payment Reduction (MPPR) is implemented for outpatient therapy services.

In her letter to CMS Administrator Mehmet Oz, Attorney General Murrill notes that while the statute requires CMS to apply a 50 percent practice expense reduction to second and subsequent services, the law leaves CMS discretion in how that reduction is operationalized at the claims-processing level. The UPTA petition asks CMS to reconsider its current methodology, which aggregates distinct therapy services across CPT codes and therapy disciplines, assuming efficiencies that often do not exist in real clinical care.

Attorney General Murrill also raises concerns that the current approach may duplicate efficiencies already embedded in the RVU valuation process, potentially compounding reductions beyond what Congress intended. She further highlights the potential impact on access to care in rural communities, where therapy providers already face significant financial pressures serving Medicare beneficiaries.

In her letter, Attorney General Murrill respectfully encourages CMS to:

• Include refinement of therapy MPPR implementation in the CY 2027 Physician Fee Schedule Proposed Rule
• Consider limiting the 50 percent practice expense reduction to additional units of the identical CPT code furnished on the same day of service
• Reevaluate whether aggregation across therapy disciplines and plan-of-care modifiers accurately reflects congressional intent and actual resource utilization

This letter underscores the importance of ensuring that Medicare payment policies are implemented in a way that faithfully reflects congressional intent, aligns with real clinical practice, and protects patient access to rehabilitation services.

We respectfully ask that your office consider sending a letter to CMS encouraging the agency to review and reconsider how MPPR is applied to therapy services. Thank you for your time and for your continued support of policies that protect access to care for Medicare patients.

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