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The Centers for Medicare and Medicaid Services (CMS) has made the following announcement regarding the Medicare therapy caps exceptions process in response to the passage of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008.
The law reinstated the therapy caps exceptions process as of July 1st. Therefore, medically necessary therapy services, in excess of the therapy caps, will continue to be paid by Medicare in accordance with the exceptions process. Claims submitted with the therapy cap exception modifier will be processed as soon as the payment rates have been activated. Claims submitted without the modifier, and rejected or denied, can be resubmitted with the modifier for reimbursement. To the extent possible, claims under the therapy cap limit, which were paid at the lower rate, will be reprocessed automatically.
For questions or further information, please contact ASHA's Healthcare Economics and Advocacy Team at reimbursement@asha.org.
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