01/30/2026
Insurance companies and all of these changes drastically affecting our children with special needs are utterly infuriating!
Thank you Beth Fleming for sharing advocating and giving professionals and parents suggestions on how to advocate!
This is a repost from Beth Fleming….
Trying to repost from my friend but it wasn’t working.., this was the Facebook message…
Caresource announced about a week ago that they will be applying a Multiple Procedure Payment Reduction for outpatient therapy services beginning February 1, 2026.
(read more here: https://www.caresource.com/documents/medicaid-ga-policy-reimburse-py-1428-20260201)
What does this mean?
MPPR stands for Multiple Procedure Payment Reduction. It’s a policy originally created for Medicare, which is for adults, to reduce payment when multiple services are provided by the same provider on the same day. The idea is that some costs are “duplicated” when a provider does multiple procedures at once, so the insurance pays less for the additional services.
Why this matters for children in the CIS program:
Georgia’s Children’s Intervention Services (CIS) program is very different from Medicare. Therapy must be provided one-on-one by fully licensed therapists, and assistants or group sessions aren’t allowed.
Applying MPPR here means if your child receives more than one therapy session in a day, the provider could be reimbursed less for the second (and any additional) session.
This could lead providers to reduce the number of sessions offered in a day, limit which children they serve, or in some cases, stop participating in CIS altogether.
For families, this may mean fewer therapy sessions, more travel, delays in care, or having to switch providers—potentially disrupting progress your child has already made.
In short: MPPR could make it harder for children to get the therapy they need, when they need it, and may create added challenges for families who rely on multiple sessions to support their child’s development.
We need providers, parents and other advocates to help try to stop this from happening.
To help out, I have created a few templates that can be used by providers and caregivers that I will post in the first few comments below.
Thank you for taking the time to advocate for your profession and for Georgia’s children.