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  • April Marks Sequestration Implementation and MPPR Increase

    March 28, 2013
    By RehabCare Medicare

    April 1, 2013 will bring with it the application of the 2% Medicare Sequester and the increase of the Multiple Payment Procedure Reduction (MPPR) percentage to 50% on the practice expense (PE) component of subsequent CPT codes for outpatient therapies.

    But what does it all mean?

    2% Medicare Sequester – As sequestration applies to all Medicare Fee for Service providers, it will impact reimbursement for Medicare Parts A and B covered therapy services. All Medicare claims with dates of service on or after April 1, 2013 will have a 2% payment reduction applied to the Medicare reimbursed portion of the claim. Sites of service paid according to discharge as opposed to per diem rates will see the 2% reduction applied to discharges on or after April 1. The reduction occurs after any copays, deductibles and any other contractual adjustments are made.

    While the sequester will reduce Medicare reimbursements through the end of this fiscal year – September 31, 2013 – it will not reduce rates. This means that any updates to Medicare reimbursement rates for next year will be based on current rates.

    50% MPPR on Outpatient Therapies – The American Taxpayer Relief Act of 2012 increased the MPPR reduction of the Practice Expense component to 50% for all outpatient therapy regardless of setting. This provision will go into effect on April 1, 2013.

    While the sequester and the changes to the MPPR are a concern to Medicare providers and therapists, at RehabCare our goal is to guarantee patients’ access to medically necessary therapy services so that we may deliver on our goal of hope, healing and recovery. By closely following the regulatory and legislative updates, we are able to navigate the changes and ensure a smooth transition to the new policies for our patients and customers alike.

    Carla Permalink
    September 29, 2015 9:22 AM

    Medicare will start on the first day of your birth month unless you were born on the first day. In your case it will start on May 1. If you were born on May 1 it would start on April 1. It never sttras on any other day of the month.You have a certain time period to sign up. If you are on social security your Medicare card will automatically be sent to you around 3 months prior to your birth month. If you are not on social security most likely you will have to sign up by contacting the social security office. You can sign up during a 7 month window which is 3 months prior to your birth month, your birth month, and 3 months after your birth month. If you sign up during or after your birth month Medicare will be effective the first day of the following month. For example, if you turn 65 on May 22 this year and you haven't contacted social security or received your card you need to do this now and Medicare will be effective June first. If you wait until sometime in June to sign up it will be effective July 1. If you do not sign up by August 31 your next window will be January 1 through March 1 for a July 1 effective date, plus you will have a Part B penalty to pay monthly forever.

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