APTA Calls for Long-term Solution to Therapy Cap

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ALEXANDRIA, VA, March 3, 2010 — The American Physical Therapy Association (APTA) joined with more than forty patient advocacy groups and health care organizations today to thank Congress for temporarily reinstating the therapy cap exceptions process and urge for a long-term solution to ensure that Medicare beneficiaries can continue receiving necessary rehabilitative services.

The Temporary Extension Act of 2010 (HR 4691), which was passed by the US House of Representatives last week and the Senate last night, was signed into law this morning by President Obama and reinstates the exceptions process that allows for services above the $1,860 financial cap based on diagnosis, clinician evaluation, and judgment until March 31, 2010. In the first 60 days of 2010, thousands of patients exceeded the $1,860 financial cap on outpatient rehabilitative services, forcing them to delay, reduce, or discontinue needed therapy because the exceptions process had expired December 31, 2009.

"We're grateful for this short-term reprieve of the therapy cap," said APTA President R. Scott Ward, PT, PhD. "However, our advocacy efforts continue for a long-term solution to this arbitrary limit on services that so negatively affects seniors and people with disabilities, many of whom have chronic conditions or comorbidities."

Imposed by the Balanced Budget Act of 1997, the therapy caps end Medicare's coverage of outpatient physical therapy, occupational therapy, and speech-language pathology services (hospital outpatient departments are exempt) billed under Medicare Part B once a beneficiary has received $1,860 of services in a calendar year. The cap exceptions process was implemented in 2006.

Physical therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility — in many cases without expensive surgery or the side effects of prescription medications. APTA represents more than 74,000 physical therapists, physical therapist assistants, and students of physical therapy nationwide. Its purpose is to improve the health and quality of life of individuals through the advancement of physical therapist practice, education, and research. In most states, patients can make an appointment directly with a physical therapist, without a physician referral. Learn more about conditions physical therapists can treat and find a physical therapist in your area at www.moveforwardpt.com. Join us on Twitter and Facebook.