{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Dynamic Chiropractic","title":"Multiple-Procedure Claim Reductions?","html":"","width":"100%","height":180,"duration":295,"description":"The article sheds light on a crucial aspect of healthcare reimbursement: the Multiple-Procedure Payment Reduction (MPPR), also known as a multi-therapy discount. This protocol, primarily initiated by Medicare (CMS) and adopted by many commercial insurers, including the VA, UnitedHealthcare, and Optum Health, impacts providers performing multiple procedures during a single patient encounter. The rationale behind MPPR is that when several services are delivered simultaneously, there's an overlap in pre- and post-procedure work, such as patient greeting, room preparation, or general counseling, which would otherwise lead to duplicative reimbursement.Under MPPR, only the highest-valued procedure is paid at full price. Subsequent services face a reduction of 50% of their \"practice expense (PE)\" component, which covers operational costs like rent, equipment, and non-physician staff, but not the physician's work or malpractice expenses. As PE constitutes about 44% of a code's total value, the overall reduction on affected services is typically a smaller, yet impactful, 7-20% of the total, often $3-$10 per service. While completely avoiding these reductions isn't feasible, practices can mitigate their impact by ensuring staff understand MPPR, listing the highest-value procedure first (based on RVU), being aware of diverse payer rules, and knowing which CPT codes, like E/M or CMT services, are exempt.","thumbnail_url":"https://img.transistorcdn.com/L9JHlAhKsM_jWCdhQPMD7P6loFfZMOCSxpA_WUWoWD8/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9lMmJh/M2U5ODNlOGFkZDYz/N2MyZDFlYmJhZGUy/MjRiNy5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}