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.
Getting Covered:
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.