Part B Therapy · Estimator

Part B Visit Estimator

Estimate what a single date of service pays under Medicare Part B: enter the day's therapy lines and the page applies MPPR and the PTA/OTA differential to show the allowed amount.

CPT code

Allowed / unit ($)

PE portion (%)

Units

Adjustments

Visit furnished in whole or part by a PTA/OTA — apply 85% (CQ/CO)

Before adjustments

Estimated allowed

Chains the rules in order: MPPR first (50% PE reduction on every unit after the highest-PE unit), then the PTA/OTA 85% differential if checked. The work and malpractice portions are never reduced.

An estimate only — uses the amounts and PE shares you enter. Confirm against the current MPFS and your MAC. CPT codes are AMA-copyrighted and referenced by number.

This sizes one visit. To accumulate visits toward the annual cap, use the KX Threshold Tracker. See also the MPPR Calculator and Billing Units.