Extension of Exceptions Process for Medicare Therapy Caps

With Congress' action of December 23, 2011, the exceptions process for outpatient therapy caps has been extended for two months. 

Contact Paul Montgomery for additional information. 
Outpatient therapy service providers may continue to submit claims with the KX modifier, when an exception is appropriate, for services furnished on or after January 1, 2012, through February 29, 2012. The therapy caps are determined on a calendar year basis, so all patients begin a new cap year on January 1, 2012. 

For physical therapy and speech language pathology services combined, the limit on incurred expenses is $1,880.  For occupational therapy services, the limit is $1,880.  Deductible and coinsurance amounts applied to therapy services count toward the amount accrued before a cap is reached, and also apply for services above the cap where the KX modifier is used.