Medicare outpatient therapy limits are set to increase slightly in 2017. Specifically, the 2017 cap will be $1,980 for physical therapy and speech-language pathology combined and $1,980 for occupational therapy, compared to $1,960 for 2016. The therapy caps exceptions process continues through December 31, 2017 under the Medicare Access and CHIP Reauthorization Act of 2015.
physical therapy
CMS Announces Plan for Medical Review of Therapy Claims Above $3,700 Threshold
CMS has released information about its plans for implementing Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) provisions regarding the manual medical review process for outpatient therapy services over the annual threshold. By way of background, the Medicare program has an annual limit on the amount of expenses a patient can accrue for outpatient…
CMS Sets 2016 Medicare Outpatient Therapy Cap Limits
CMS has announced that the CY 2016 Medicare outpatient therapy limits are $1,960 for physical therapy and speech-language pathology combined and $1,960 for occupational therapy, compared to $1,940 for 2015. The Medicare Access and CHIP Reauthorization Act of 2015 extended the therapy caps exceptions process through December 31, 2017.
Congressional Health Policy Hearings
A number of recent Congressional hearings have focused on health policy issues, including the following:
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Senate Finance Committee to Vote on Bipartisan Health Bills
On June 24, 2015, the Senate Finance Committee is scheduled to vote on the following bipartisan health policy bills, described by Chairman Hatch as “common sense legislation that will improve the healthcare system for patients and taxpayers alike”:
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CMS Updates Outpatient Therapy Caps for 2015
CMS has announced that the CY 2015 Medicare outpatient therapy limit is $1,940 for physical therapy and speech-language pathology combined and $1,940 for occupational therapy. The therapy cap exceptions process was extended through March 31, 2015 by the Protecting Access to Medicare Act of 2014.
GAO Assesses Trends in Medicare Physical Therapy Self-Referrals
The GAO recently examined “self-referral” for outpatient physical therapy (PT) services, which the GAO defines as a provider referring patients to entities in which the provider or the provider’s family members have a financial interest. According to the GAO, non-self-referred PT services per 1,000 Medicare FFS beneficiaries increased by 41% from 2004 to 2010, while…
Bill Introduced to Narrow Stark Exception for In-Office Services
This post was also written by Rachel Golick. A new bill introduced in the House on August 1, 2013 by Congresswoman Jackie Speier (D-CA) and Congressman Jim McDermott (D-WI) would dramatically narrow the in-office ancillary services (IOAS) exception to the Stark law for physician groups performing imaging, pathology radiation therapy and physical therapy services. The…