ASHA to Congress: Eliminate Outdated Payment Policy That Hurts Patients and Providers

March 20, 2026

ASHA and a coalition of organizations representing therapy providers have joined forces to urge Congress to end the Multiple Procedure Payment Reduction (MPPR) policy. The MPPR arbitrarily and inappropriately reduces payment for essential speech-language pathology services, jeopardizing patients' access to care.

While Medicare continues to pay in full for the procedure with the highest practice expense, MPPR applies a 50% reduction to the practice expense of the second and any subsequent CPT codes for any therapy services provided to the patient on the same day. The policy applies to physical therapy (PT), occupational therapy (OT), and speech therapy (ST) services provided under Medicare Part B, regardless of setting. The policy does not differentiate the therapy disciplines and cuts payments to PT, OT, and ST providers.

While other payers are not required to adopt the MPPR, many have-often in different ways. For example, rather than cutting the practice expense value by 50%, some payers have applied the reduction to the full value of the CPT code, creating even larger payment decreases and compounding the impact of the Medicare policy.

ASHA recently sent letters to leaders of the Senate Finance Committee [PDF] and House Energy and Commerce Committee [PDF] urging repeal of the outdated policy and fundamental reform to payments under the Medicare Physician Fee Schedule to ensure therapy providers are paid appropriately and that beneficiaries maintain access to their services.

ASHA President Linda Rosa-Lugo was highlighted in the press release announcing the repeal effort, noting that "the payment reductions resulting from the Multiple Procedure Payment Reduction Policy-combined with ongoing annual Medicare cuts-continue to jeopardize patient access to vital speech, language, swallowing, and cognitive-communication services. These services are central to the health and well-being of older Americans and help reduce overall health care costs, ultimately saving taxpayer dollars."

ASHA has advocated to protect SLPs from the impacts of MPPR across the country and implementation of this policy by different payers for years. Some states, such as Colorado, have even passed state laws preventing this type of reduction by other payers, like Medicaid. The Colorado Speech-Language-Hearing Association worked with ASHA and the Colorado TriAlliance (ST/OT/PT) to avoid proposed legislation that would have put MPPR in place.

What's Next?

ASHA will continue urging Congress to eliminate the MPPR policy and modernize the Medicare Physician Fee Schedule to ensure that SLPs are reimbursed appropriately for their services and patients have access to the critical care SLPs provide.

In another effort to ensure SLPs are reimbursed properly, you can join ASHA in advocacy by asking Congress to pass the Efficiency Adjustment Delay Act. This legislation would prevent a 2.5% "efficiency adjustment" reduction to the value of certain CPT codes, which compounds the detrimental impact of MPPR and numerous other Medicare payment cuts.

Questions?

Contact Josh Krantz, ASHA's associate director of federal affairs, health care, at [email protected], or the Health Care Education and Policy team at [email protected].