I've heard there's a cap on outpatient therapy services. What does this mean?
There is an outpatient therapy cap for Medicare, which is currently under moratorium (through 12/1/2012). We are able to exceed the cap for medically necessary services through the use of a "modifier" on our claim.
Should the cap become effective, there is a combined cap for physical and speech therapy, while occupational therapy has been granted its own cap.
There are people working toward
1) permanent repeal of the cap;
2) separation of speech therapy services from physical therapy services, such that each has its own cap.
Those interested in registering their opinion on this should contact their legislators.
Give us both your Medicare information and your Secondary Insurance information Medicare Part B (outpatient rehabilitation) pays only 80% of covered services. The majority of subscribers purchase a "secondary insurance" to cover the rest of the bill. In order for us to properly bill your secondary insurance, we need to have the policy information.