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The exceptions process for patients needing physical, occupational, and speech therapy beyond the capped amount ended December 31, 2009.


Currently there are two therapy caps, one for physical therapy and speech therapy combined and one for occupational therapy. The 2010 therapy caps are set at $1860 per beneficiary per year. The therapy cap applies to all Medicare beneficiaries in all Part B health care settings, except hospital outpatient departments. Beneficiaries that exceed their therapy cap may have to choose between forgoing necessary care or paying 100% of the cost out-of-pocket over their Medicare coverage.

Therapists should make their patients aware of this and let them know that there is something they can do about it.

Patients may visit:  http://capwiz.com/amerpta/issues/alert/?alertid=14421306&PROCESS=Take+Action

and contact their members of Congress via email or printed letter.  An editable template letter has already been drafted there making it easy for them to do so.  Or therapists may wish to print copies of the text itself from the above webpage to give to their patients to use who may not have internet access.

Let’s work together to stop the therapy caps once and for all!