Medicare Therapy Cap

Under the Balanced Budget Act (BBA) of 1997 Congress placed an annual cap on rehabilitation services under Medicare. As part of the Deficit Reduction Act (DRA) in 2006, Congress passed legislation implementing the therapy caps but authorizing the Centers for Medicare and Medicaid Services (CMS) to create and employ an exceptions process to permit medically necessary physical therapy, occupational therapy, and speech language pathology services above cap. On April 14, 2011, Congressmen Jim Gerlach (R-PA) and Xavier Becerra (D-CA) and Senators Ben Cardin (D-MD) and Susan Collins (R-ME) introduced The Medicare Access to Rehabilitation Services Act (HR 1546/S 829). This legislation seeks to repeal the cap on therapy services for Medicare beneficiaries.

On February 22,2012, President Obama signed a measure to extend the therapy cap exceptions until December 31, 2012. If Congress does not take action by December 31, 2012, a hard therapy cap will again be imposed on Medicare-covered therapy. For the latest updates on the therapy cap visit the Latest Legislative Action page. If you'd like additional updates on this and other legislative issues, join PTeam today!

• FAQ: 2012 Medicare Therapy Cap Update - 2/23/12
• Podcast: 2012 Medicare Therapy Cap Update - 2/23/12
• President Signs Legislation Inclusive of Medicare Payment Cut Reprieve and Therapy Cap Exceptions Process Extension - 2/23/12
• Therapy Cap Coalition Urges Congress to Protect Services (.pdf) - 2/14/12
• Medicare Therapy Cap Coalition: Letter to Conference Committee Members (.pdf) - 1/27/12
• Podcast: 2012 Therapy Cap Short Term Extension Update - 1/12/12

Background

• Ways and Means Testimony: Expiring Medicare Provider Payment Policies (.pdf) - 9/21/11
• Position Paper: Medicare Therapy Cap (.pdf)
• History of Medicare Therapy Caps

Current Cosponsors

• HR 1546
• S 829

Resources

• 2011 Impact: General Background and Information
• Supporting Organizations

• Last Updated: 2/23/2012
• Contact: advocacy@apta.org
• = Members Only