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We track each beneficiary's incurred expenses for therapy services annually and count them towards the KX modifier and MR thresholds by applying the PFS rate for each service less any applicable multiple procedure payment reduction (MPPR) amount for services of CMS-designated always therapy services (see the CY 2011 PFS final rule at 75 FR 73236)

References 1.Sahoo S.K., Ghuman M.S., Salunke P., Vyas S., Bhar R., Khandelwal N.K