The American Physical Therapy Association (APTA), Alexandria, Va, has joined with more than 40 patient advocacy groups and health care organizations 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 needed rehabilitative services.

The Temporary Extension Act of 2010 (HR 4691), which was recently passed by the House of Representatives and the Senate, was signed into law 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. 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.

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.

[Source: APTA]