Medicare AdvantageReimbursementMedium impact
MA00.050c, Multiple Procedure Payment Reduction Guidelines for Physical, Occupational, and Speech Therapy Services
Independence Blue Cross·Physical Therapy, Occupational Therapy, PM&R (Physical Medicine & Rehab)·Claims & Billing
Effective date
Dec 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage plans have updated their multiple procedure payment reduction guidelines for physical therapy, occupational therapy, and speech therapy services. This affects how these services are reimbursed when multiple procedures are performed during the same session.
Action Required
Before December 1, 2025: Billing team must review and update billing procedures for physical, occupational, and speech therapy services to comply with new multiple procedure payment reduction guidelines. Update billing software to reflect new reimbursement calculations when multiple therapy procedures are performed in the same session. Train therapy staff on documentation requirements to support proper billing.