Corporate Compliance

Note from the Instructor: CMS issues further guidance on outpatient therapy caps and the related exceptions process

Medicare Insider, May 8, 2012

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In a recent transmittal, CMS issued guidance on Congress’ extension of limitations on certain therapy services, as well as the related exceptions process, through December 31, 2012.  Under the Balanced Budget Act of 1997, Congress initially imposed financial limitations on specific outpatient therapy services (physical, occupational and speech-language pathology) provided in all settings except hospital outpatient departments and clinics. Subsequently, Congress enacted certain exceptions to these limitations. 

Extension of Therapy Caps

Under the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA), Congress generally extended the 2012 therapy caps -- $1,880 for occupational therapy services (OT) and $1,880 for the combined services for physical therapy (PT) and speech-language pathology (SLP) – through December 31, 2012. In addition, Congress specifically extended the application of these therapy rules, on a temporary basis, for therapy services provided in hospital outpatient settings, limited to dates of service on and after October 1, 2012 through December 31, 2012. 

Continue reading Judith's note at the Medicare Mentor Blog



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