tci Medicare Compliance & Reimbursement - 2015 Issue 10

Therapy Caps: Yes, You Still Have The Therapy Cap Exceptions Process

Industry stakeholders won’t give up the fight to eliminate cap. Although passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a boon to overall Medicare reimbursement, your therapy reimbursement is still subject to the therapy cap — but you can use the exceptions process for another two years. Like the Sustainable Growth Rate (SGR) formula patch, the therapy cap exceptions process was set to expire as of March 31, 2015. If the exceptions process expired, an annual hard cap of $1,940 would have been in place for therapy services effective April 1. But...

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