American Speech-Language-Hearing Association

Medicare Fees and Therapy Cap Exceptions Process Addressed In Fiscal Cliff Legislation

(January 3, 2013)

Congress averted cuts to the Medicare fee schedule and extended the therapy caps exceptions process through December 31, 2013, as part of the fiscal cliff legislation (H.R. 8, the American Taxpayer Relief Act of 2012) passed by the House of Representatives. The Senate approved the legislation earlier in the week and President Obama signed the bill into law via autopen on Wednesday, January 2, 2013.

Impact on ASHA Members

The following health provisions were included in the law.

  • Current rates in the Medicare Physician Fee Schedule will be extended through December 31, 2013.
  • There will be a 2-month delay on Medicare payment cuts that were initially required under sequestration.
  • The therapy caps exceptions process and manual medical review process will be extended through December 31, 2013.
  • Hospital outpatient departments and outpatient critical access hospital services will be subject to the therapy caps exceptions process and medical manual review.
  • There will be a 50% multiple procedure payment reduction (MPPR) on outpatient therapy services effective on April 1, 2013.

ASHA Resources

For information related to the congressional action, please contact Ingrida Lusis, ASHA’s director of federal and political advocacy, at ilusis@asha.org. Questions related to implementation of the therapy caps by the Centers for Medicare and Medicaid Services and to MPPR reductions can be addressed to reimbursement@asha.org.


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