Medicare Part B Therapy Cap Exceptions Process
On January 3, 2013, the president signed into law the "American Taxpayer Relief Act of 2012," which extended the therapy cap exceptions process and manual medical review for therapy services in 2013. The following provides speech-language pathologists with relevant information on the exceptions process, manual medical review process, and documentation requirements. Speech-language pathologists may use the automatic exceptions process for any diagnosis and complexity, so long as they have documented justification on why the services for the particular patient exceed the cap. The 2013 therapy cap is $1,900 for speech-language pathology and physical therapy services combined.
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