Health Care Organizations Jointly Appeal to Congress to Abolish the MPPR Policy

In a significant move, the American Physical Therapy Association (APTA) and a coalition of various rehabilitation and health care organizations have put forth a pressing appeal to Congress, demanding the cessation of the Multiple Procedure Payment Reduction (MPPR) policy. This policy, which is part of Medicare's framework, has been flagged as detrimental to patient access to crucial rehabilitation services and poses a severe threat to the viability of therapy providers across the nation.

On March 17, 2026, letters were sent to the Senate Committee on Finance and the House Committee on Energy and Commerce. In these communications, the coalition articulated the need for a repeal of the MPPR policy, emphasizing that it is part of the larger reform necessary for the Medicare Physician Fee Schedule. The organizations expressed their concerns that the MPPR policy not only undermines coordinated and evidence-based rehabilitation care but also erects significant barriers to access for Medicare beneficiaries, particularly those residing in rural and medically underserved areas.

Kyle Covington, President of APTA, emphasized the importance of timely and coordinated rehabilitation care, free from restrictive payment policies. He stated, "MPPR was never intended to address the complexities of interdisciplinary therapy. Instead, it discourages efficient care delivery, threatens the financial stability of therapy providers, and ultimately risks delaying recovery for Medicare beneficiaries.” Covington and his colleagues assert that revoking the MPPR policy is essential as Congress undertakes reforms to the Medicare Physician Fee Schedule.

The MPPR policy has been in effect for over a decade, initially set up as a temporary budgetary measure. It applies to various services including physical therapy, occupational therapy, and speech-language pathology under Medicare Part B. The controversial policy penalizes providers who bill multiple therapy services for a single beneficiary on the same day. Specifically, it reduces the practice expense component by 50% for every therapy service billed after the first. Given that practice expense constitutes about 45% of a CPT code's value, these reductions undermine the financial viability of therapy services.

Moreover, the MPPR policy fails to appreciate that occupational therapy, physical therapy, and speech-language pathology services are distinct from one another. This lack of recognition significantly impacts beneficiaries suffering from complex medical conditions, particularly in rural and underserved locations where inefficiencies related to transportation necessitate multiple therapy sessions on the same day.

Mike Horsfield, the President of APTA Private Practice, further urged Congress to act, pointing out that the elimination of MPPR would bolster community-based providers and ensure that older adults have access to the rehabilitative services they need without undue barriers.

Katie Jordan, CEO of the American Occupational Therapy Association (AOTA), shed light on the alarming trend that occupational therapy practitioners are witnessing lower payment rates today than they did in 2009, primarily due to the MPPR policy. She stressed that small practices, particularly in rural and underserved areas, often struggle to remain afloat due to these punitive payment reductions. Jordan called for the repeal of MPPR to safeguard older Americans' access to occupational therapy services.

Linda I. Rosa‑Lugo, President of the American Speech-Language-Hearing Association (ASHA), echoed these sentiments, asserting that the outdated MPPR policy creates untenable payment reductions for speech-language pathologists providing essential care. She highlighted that these reductions, compounded by ongoing Medicare cuts, could adversely affect patients' access to vital services that are fundamental to their health and wellbeing.

Furthermore, the coalition of health care organizations argues that the detrimental impacts of the MPPR policy exacerbate the challenges faced by rehabilitation providers already grappling with extensive payment pressures under the physician fee schedule. These pressures include a notable 15% decrease in payments for services rendered by therapy assistants and cumulative annual cuts since 2020. Together, these policies threaten the sustainability of clinics, particularly those that are smaller and located in rural areas, thereby jeopardizing patient access to necessary rehabilitation therapies.

In conclusion, the APTA, alongside its partners, remains steadfast in its commitment to cooperating with Congress to enact necessary changes to the fee schedule—ones that will foster coordinated, patient-centered rehabilitation and accurately reflect the complexities of clinical care. Endorsing this initiative are influential organizations including ADVION, Alliance for Physical Therapy Quality and Innovation, American Health Care Association/National Center for Assisted Living, American Occupational Therapy Association, and the National Association of Rehabilitation Providers and Agencies, among others.

For further information on this topic, you can visit the APTA website, which represents over 100,000 professionals in the field of physical therapy across the United States.