Tuesday, November 25, 2014

CMS Provides Part B Therapy Cap Updates for 2015

Dan Ciolek
The Centers for Medicare and Medicaid Services (CMS) recently posted a MLN Matters article MM8970 – Therapy Cap Values for Calendar Year (CY) 2015 that indicates that the cap threshold will increase $20 in 2015 to $1,940 per year for physical therapy (PT) and speech-language pathology (SLP) services combined, and $1940 per year for occupational therapy (OT) services.

An exceptions process to the therapy caps for reasonable and medically necessary services was required by section 5107 of the Deficit Reduction Act of 2005. The exceptions process for the therapy caps has been continuously extended several times through subsequent legislation. Most recently, section 103 of the Protecting Access to Medicare Act of 2014 extended the therapy caps exceptions process through March 31, 2015. For questions please contact Dan Ciolek at dciolek@ahca.org

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