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  • CMS to Provide Data on Dollars Accrued Toward Cap on October 8

    On Monday, the therapy cap with an exceptions process went into effect for outpatient hospitals. In addition, the manual medical review exceptions process for claims exceeding $3,700 became effective for phase I providers. Originally, the Centers for Medicare and Medicaid Services (CMS) had announced that providers would know the dollar amount that their patients accrued toward the therapy cap on October 1. Due to some systems challenges, this information was not available. CMS announced this week that the information will be available October 8 through eligibility inquiries. Physical therapists (PTs) should check with their Medicare Administrative Contractors to determine the best way to obtain the dollar amounts accrued. When the data is available on October 8, PTs can then determine whether there is a need to seek an exception to the therapy cap.

    To help PTs with the implementation of the cap and the manual medical review exceptions process, APTA has created a Medicare Therapy Cap Resources webpage. This webpage compiles relevant information available from APTA and CMS in 1 place.


    • Where are our press releases to patients to fight for Medicare coverage?

      Posted by Brett Michener on 10/4/2012 7:59 AM

    • Does that mean the information I've retrieved all week is incorrect? We've been seeing patients all week, thinking we had correct information! Will the information be available on the Palmetto GBA website? It has not had any information this week.

      Posted by Charles Tanner -> >JRcEN on 10/5/2012 12:04 PM

    • What is the bext way to checl therapy dollar amounts? Is it C-SNAP or HETS? What is working in NJ?

      Posted by Nisha on 10/10/2012 12:08 PM

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