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Outpatient Rehabilitation Therapy Cap - PowerPoint PPT Presentation


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Rehab Industry is working together to solve problems thrown way. Outpatients is one of the problems which qualify for an exception to the therapy cap limits. Here we share points for your therapy services after you reach the therapy cap limits and help you to find the Best Rehabilitation Center in Delhi. Check the link below: http://www.wbcindia.in/rehabilitions.php

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Presentation Transcript
therapy cap

Therapy Cap

● Therapy caps are Medicare law which limits how much it

pays for your medically necessary outpatient therapy

services in one calendar year.

● The therapy cap is exception process for use of the KX

modifier and the manual medical review (MMR) process.

therapy cap updates

Therapy Cap Updates

● Hospital OP Clinics are exempt from the therapy cap, they

do NOT have to track against the limit of $2,010.

● Non-hospital-based outpatient therapy settings are NOT

exempt from the therapy cap.

● All Medicare beneficiaries that exceed the $2,010 amount

in these settings will be statutorily responsible to pay the

provider for any therapy services that exceed the therapy

cap.

latest update from cms

Latest Update from CMS

● CMS is committed to implementing the Medicare program

in accordance with applicable laws and regulations,

including timely claims processing.

● CMS will hold all newly received therapy claims with the

KX modifier and implement a “rolling hold”.

what to do now

What to do now?

● Try to minimize the touches you need to do for your

Medicare Authorizations during this uncertainty period.

● Assure that if the therapy exception process is extended,

the tracking of the therapy cap will not be interrupted.

● Continue to conduct business as if the therapy cap with

KX modifier is in place.

thank you

Thank You

www.wbcindia.com