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Multiple Procedure Payment Reduction (MPPR) for Selected Therapy Services

Feb 11, 2015
Shamis & Gentile, P.A.

Miami PIP Attorneys – Personal Injury Protection Lawyers

Did you know that pursuant to the new 2013 PIP statute certain insurance companies feel entitled to utilize MPPR reductions? Each individual insurance contract allows and disallows certain reductions to be made. Not every reduction is done properly, and some are not even permissible pursuant to that particular contract.

MPPR Reductions – Don’t be taken advantage of

Don’t be taken advantage of by improper reductions. Contact us today if you have any questions regarding MPPR reductions.

Section 3134 of The Affordable Care Act added section 1848(c)(2)(K) of The
Social Security Act, which specifies that the Secretary of Health and Human
Services shall identify potentially misvalued codes by examining multiple codes
that are frequently billed in conjunction with furnishing a single service. As a step
in implementing this provision, Medicare is applying a new MPPR to the PE
component of payment of select therapy services paid under the MPFS. The
reduction will be similar to that currently applied to multiple surgical procedures
and to diagnostic imaging procedures. This policy is discussed in the CY 2011
MPFS final rule.  Click here to read more

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