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  • APTA Issues a 'Call to Action' for Patient Videos on Therapy Cap

    After a brief shutdown, the federal government is up and running—but there's still no resolution to the hard cap still in place for therapy under Medicare. With lawmakers facing a February 8 deadline for coming up with a spending plan, now is the time to act to advocate for a bipartisan, bicameral deal to end the hard therapy once and for all.

    To that end, APTA launched a new call for grassroots advocacy—this time through videos of patients affected by the hard cap. Following is the email sent to all members that contains instructions for participating in the effort. Deadline for videos is February 2, 5:00 pm ET.

    Submit Your Patient Story
    We are at a critical point in the legislative process involving the Therapy Cap. It is more important now than ever that we keep our voices loud and strong so that we are heard by our representatives. To do that we’d like to enlist our member’s help in gathering very brief video testimonials from their patients who are affected by the hard cap.

    What You Can Do

    • Select a patient who has been/will be affected by the cap.
    • Ask her/him if she/he would be willing to be filmed briefly and allow you to pass along to us to share on our website and promote via social media.
    • Film 20-30 seconds using below script.
    • Ask her/him to sign [a required] video/photo release form, granting us ownership and permission to share.
    • Send video and signed release form to Amelia Sullivan at ameliasullivan@apta.org with “Stop the Cap Patient Testimonial” in the subject line.

    Record a simple and quick video, no more than 30 seconds, by having your patient say the following:

    “Hi. I am [PATIENT FIRST NAME] and I have/had (a) [NAME OF CONDITION, (ie, stroke). Physical therapy helps me [describe]. Because of the therapy cap, I won't get the care that I need. Congress – you must Stop the Cap.”

    Note: It is important to be conscious of background, good lighting, and audio, so please take a moment to check each.

    Please submit your video and the signed release form via email to ameliasullivan@apta.org.

    Other Therapy Cap News

    Claims above the hard cap being held
    Recently, the US Centers for Medicare and Medicaid Services (CMS) reported that the agency has been holding all outpatient therapy claims since January 1 that go above the $2,010 cap. CMS is expected to begin processing those claims in the near future, but has not yet provided a time line.

    Use of KX modifier recommended
    CMS has stated that providers should continue to submit claims with the KX modifier, even though the exceptions process is not in place, under the assumption that Congress will retroactively apply a permanent therapy cap fix.

    APTA continues to push CMS to issue additional guidance on claims impacted by the hard cap, and shares information with members as it becomes available. Please see APTA’s revised FAQ document for more details.