Eli's Rehab Report

Published on Mon Apr 28, 2014 PDF

KX modifiers are back.

If you furnish outpatient therapy in the home under the Part B benefit, you have almost another year to breathe easy on therapy caps.

The latest “doc fix” bill that was signed into law, which averted physicians’ Medicare payment rate cuts and postponed the ICD-10 deadline, also contained a provision on therapy caps. “The new law extends the exceptions process for outpatient therapy caps through March 31, 2015,” explains the Centers for Medicare & Medicaid Services (CMS) in a notice sent via its Medicare Administrative Contractors. “Providers of outpatient therapy services are required to submit the KX modifier on their therapy claims, when an exception to the cap is requested for medically necessary services furnished through March 31, 2015.”

Plus: “The new law extends the application of the caps, exceptions process, and threshold to therapy services furnished in a hospital outpatient department (OPD),” the MACs add.