Part B Insider (Multispecialty) Coding Alert

Published on Thu Sep 27, 2012 PDF

Part B isn't the only area where therapy caps are becoming a problem.

CMS "began issuing its therapy cap letter to Medicare beneficiaries who are receiving home health under Part A, resulting in patients cancelling appointments," reports the American Physical Therapy Association. The letters fail to explain that therapy furnished under a Part A home health plan of care aren't affected by the cap.

The solution: Providers will have to educate beneficiaries to avoid appointment cancellations and other related problems that are already occurring. "APTA has updated its patient FAQs to explicitly state that the cap does not apply to patients who receive skilled therapy at home under the Medicare home health benefit Part A, those who receive services under Part A in skilled nursing facilities, or those under a Part A inpatient hospital stay," the trade group says.