Latest Developments
Congress Overrides Presidential Veto to Pass Medicare Relief Legislation
SLP Private Practice Direct Billing and Audiology Quality Reporting Bonus Now Law!
Background on Therapy Caps
The Medicare cap on outpatient rehabilitation therapy services was originally instituted under the Balanced Budget Act of 1997 as a combined cap on speech-language pathology (SLP) and physical therapy (PT) services, as well as a separate cap on occupational therapy (OT) services to Medicare beneficiaries.
The original $1500 cap on Part B Medicare therapy services was intended as a cost control mechanism, but has not proved effective in saving Medicare money. Instead, it has punished the sickest of Medicare patients and denied them needed care. Congress has recognized that a financial limitation on therapy is detrimental to Medicare patients and through the years placed numerous moratoriums on its implementation. In December 2007, the President signed the Medicare, Medicaid, and SCHIP Extension Act of 2007 into law. The law directed CMS to continue to allow exceptions to therapy caps for certain medically necessary services provided on or after January 1, 2008 through June 30, 2008. On July 15, 2008, the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 was passed that removes the June 30 endpoint and extends the exceptions process to December 31, 2009.
The current therapy cap is $1,810 for speech-language pathology and physical therapy combined.
Additional Resources
Archives - ASHA's previous advocacy efforts on the Medicare Therapy Cap Advocacy Campaign
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