Coalition Pushes Congress to Repeal MPPR as Part of Medicare Payment Reform

A coalition of national rehabilitation and health care organizations is urging Congress to repeal the Multiple Procedure Payment Reduction policy. The outdated Medicare Part B payment policy, also known as MPPR, continues to undermine patient access to rehabilitation services and threaten the financial sustainability of therapy providers.

In letters sent on March 17 to the Senate Committee on Finance and the House Committee on Energy and Commerce, APTA and its partners called on Congress to eliminate MPPR as part of broader reforms to the Medicare Physician Fee Schedule. The coalition emphasized that MPPR no longer reflects clinical realities and actively discourages coordinated, patient-centered care.

Other endorsing organizations joining the effort include: ADVION, Alliance for Physical Therapy Quality and Innovation, American Health Care Association/National Center for Assisted Living, American Occupational Therapy Association, APTA Private Practice, American Speech-Hearing-Language Association, Athletico, National Association of Rehabilitation Providers and Agencies, and Select Medical.

Why MPPR Repeal Matters to the Profession

For PTs and PTAs, MPPR directly affects how care is delivered and billed. Under MPPR, when a provider bills more than one "always therapy" service, identified by CPT code, on the same day for the same patient, all therapy services beyond the first service unit are subject to a 50% reduction in the practice expense portion, including subsequent units of the same service and any additional service codes billed, regardless of whether those services are distinct, medically necessary, or provided by different disciplines.

Because practice expenses make up a significant portion of therapy reimbursement, MPPR results in substantial payment reductions that fail to account for the resources required to deliver high-quality rehabilitation care. These cuts are especially harmful for patients with complex conditions, and for providers serving rural and medically underserved communities where scheduling multiple services on the same day is often essential.

In its press release, APTA leaders stressed that MPPR creates unnecessary barriers for Medicare beneficiaries and destabilizes therapy practices at a time when demand for rehabilitation services continues to grow.

"Patients deserve timely, coordinated, high-quality rehabilitation care without arbitrary payment policies getting in the way," says APTA President Kyle Covington, PT, DPT, PhD. "MPPR was never designed for the realities of interdisciplinary therapy. It discourages efficient care delivery, creates financial instability for therapy providers, and ultimately risks delaying recovery for Medicare beneficiaries. Congress must repeal MPPR as part of any Medicare Physician Fee Schedule reforms."

MPPR Adds to Ongoing Payment Pressures

The coalition also highlighted that MPPR compounds other recent Medicare payment challenges facing therapy providers, including reductions in payment for services furnished by therapy assistants and cumulative annual cuts under the physician fee schedule since 2020. Together, these policies place increasing strain on practices, particularly smaller community-based clinics, and jeopardize patient access to medically necessary care.

APTA Private Practice emphasizes that repealing MPPR is critical to preserving access to care close to home.

"It is time for Congress to act and eliminate this outdated policy and arbitrary payment cut that limits older adults' access to rehabilitative services," says APTA Private Practice President Mike Horsfield, PT, MBA. "Removing MPPR will help ensure community-based providers can continue delivering the care Medicare beneficiaries deserve close to home."

Repealing MPPR Is Part of the Solution to Improving Payment

Improving payment remains APTA's top advocacy priority, and repealing MPPR is a key part of achieving a Medicare payment system that supports the sustainability of therapy providers. APTA is working with its coalition partners to introduce a bill in the U.S. House that would repeal MPPR as part of its current advocacy efforts to reform payment under the fee schedule.

Medicare payment reform, including the repeal of MPPR, will be front and center this April as part of APTA's Capitol Hill Day, where members will come together in Washington, D.C., to connect, advocate, and make an impact alongside fellow physical therapy professionals and students. Register to attend APTA's Capitol Hill Day today.

APTA members play a vital role in this effort by sharing their stories with lawmakers and by reinforcing how outdated payment policies, such as MPPR, affect patient care in their communities. As advocacy continues, APTA remains committed to ensuring Medicare payment policies support, rather than hinder, high-quality physical therapy services.

Get the latest updates on the association's work to advance payment by joining APTA's Advocacy Network and by subscribing to APTA's Payment Friday Focus in your email preferences.