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 are implementing new multiple procedure payment reduction guidelines for physical therapy, occupational therapy, and speech therapy services. This will affect how these therapy 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. Contact Medicare Advantage plans for specific reduction percentages and affected procedure combinations. Update billing software to calculate proper reimbursement when multiple therapy procedures are billed together.