Medicare Payment Adjustment (MPA) Report

The Medicare Payment Adjustment (MPA) Report allows users to see how MPPR is affecting their clinics’ profits and losses. Most practice management systems do not provide this data, so this report gives clinics a significant advantage, as they can assess the impact of MPPR and adjust their processes accordingly.

Creating a Report

1. Select MPA Report from the Reports section.                                             
2. Choose a Time Period from the drop-down.
3. Begin typing in the patient's name in the Patient search box. They must be a Medicare patient with billable, finalized notes. Enter in a minimum of three letters into the Patient search field and select the correct patient from the drop-down list. 
4. Generate the report. 
5. The report displays as a results page with payment adjustment data for the patient you selected. The data displayed on this page reflects the search criteria you used for this patient. 

• Total Adjusted Reimbursement: The total expected reimbursement (rounded to the nearest dollar) based on the Medicare Allowable Fee Schedule and the MPPR adjustments.
• Total Net Change: The difference (rounded to the nearest dollar) between the Medicare Allowable Fee Schedule value and the expected reimbursement amount.
• Date of Service: Dates of service associated with each case.
• Visit Total: The total number of units, adjusted reimbursement, and net change for that particular date of service.
• Case Total: The total number of units, adjusted reimbursement, and net change for the entire case.

According to the Centers for Medicare & Medicaid Services (CMS), the MPPR-applied discount for institutional and non-institutional facilities will be 50% on the second and subsequent procedure each day. You can view fee amounts inside the Medicare Fee Schedule. We pull these fees directly from CMS.

For more on MPPR calculations and formulas, check out this CMS page and APTA page.