A Reprieve for Therapy Caps

We were pleased to see Congress pass an important measure to prevent the Medicare Therapy Cap, which would have resulted in a staggering 27.4% cut in payments. What does this new measure mean for physical therapy, speech language pathology, and occupational therapy providers in 2012?

In the near term, it provides a 10-month extension of therapy caps – more time for our nation’s leaders to craft better protocols for the therapy payment system. Until then, the exceptions process will entail the following requirements:

• The implementation of the KX modifier at the cap of $1880.
• A manual medical review for patients who meet or exceed $3,700 in combined physical therapy/speech therapy or $3,700 in occupational therapy expenditures, starting October 1st.
• A National Provider Identifier of the physician who reviews the patient’s care plan, also beginning October 1st.

As our government leaders continue to shape the laws that will affect the way we deliver patient care, we encourage all of our physical therapy colleagues to make their voices heard through the APTA’s Legislation Action Center.

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