Therapy Cap for Hospital Based OP

[Guest guest]

Being in a hospital based OP therapy department, we have not paid

attention to the OP Therapy Cap. Now that it is going to apply to the

hospital based departments, is there a simple breakdown of OP therapy

Cap process? It would be helpful to know:

1. Does the benefit amount refer to billed charges?

2. What is KX modifier?

3. Process used by private clinics to ensure compliance with this

provision?

I appreciate any information.

Thanks.

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