Therapy Cap Exceptions and Repeal

The Medicare Therapy Cap, which limits annual per-person spending on physical and speech therapy services to $1,880, is a hotly debated issues in the physical therapy community. Exemptions to this rule have been put into place for those needing extensive therapy. On February 22, 2012 President Obama signed a measure to extend these exemptions until December 31, 2012 only. This means if Congress does not take action by December 31, 2012, a hard therapy cap will be placed on Medicare covered therapy again.

 The Medicare Access to Rehabilitation Services Act, or H.R. 1546/S. 829, has been proposed to repeal the cap totally. To learn more, support and track the bill, visit its Open Congress page. 

Update 8/6/12: Center for Medicare and Medicaid Services (CMS) have made changes this week to the therapy cap exceptions process. New provisions, going into effect October 1, 2012 include: applying therapy caps to outpatient hospitals, new threshold amounts of $3,700 (one for each therapy cap amount), and requiring a manual medical review process of claims over these new thresholds.  Read more about these changes in detail from the CMS here

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