Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012 As I answer this email, the therapy cap exception process is exactly the same as it has been the last several years. The therapy cap exception process remains in effect through February 29, 2012. The therapy cap dollar amount for 2012 is $1880 for PT and SLP combined and a separate $1880 for OT. In a House bill in December 2011 that was defeated by the Senate, the House proposed a 2-tiered therapy cap. When the patient reached $1880 in 2012, it would have required mandated use of the KX-modifier. If the patient then reached $3700 in PT and SLP combined services or $3700 in OT services, the bill wold have required a manual review of the medical record by your Medicare contractor. The House and Senate have begun work to come up with a longer term fix for the therapy cap, therapy cap exception process, and the SRG formula that impacts the Medicare Physician Fee Schedule. Stay tuned for updates. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. www.gawendaseminars.com Follow Gawenda Seminars & Consulting, Inc on Facebook Register for the February 22, 2012 audio conference: " Is Your Practice Profitable? Evaluating Practice Metrics, Part 1 " at https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1754 Subject: Re: KX Modifier To: " PTManager " <PTManager > Date: Tuesday, January 31, 2012, 6:44 AM Â I was told by a colleague that Medicare had announced they are now limiting the amount of automatic approvals when provides use the acceptable modifier and will begin requiring supportive documentation when a $ threshold is exceeded. Has anyone heard anything on this topic? Witt,PT Segal & Witt Physical Therapy C O wittpt@... Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.