Therapy Cap Advocacy Center
Latest Developments
Background on Therapy Caps
The Medicare cap on outpatient rehabilitation therapy services was originally instituted under the Balanced Budget Act of 1997 as a combined cap on speech-language pathology (SLP) and physical therapy (PT) services, as well as a separate cap on occupational therapy (OT) services to Medicare beneficiaries.
The original $1,500 cap on Part B Medicare therapy services was intended as a cost control mechanism, but has not proved effective in saving Medicare money. Instead, it has punished the sickest of Medicare patients and denied them needed care. Congress has recognized that a financial limitation on therapy is detrimental to Medicare patients and through the years placed numerous moratoriums on its implementation. On December 23, 2011, the president signed the Temporary Payroll Tax Cut Continuation Act of 2011 into law. The law directed CMS to continue to allow exceptions to therapy caps for certain medically necessary services provided on or after January 1, 2012, through February 29, 2012.
The current therapy cap is $1,880 for speech-language pathology and physical therapy combined.
Advocate
Here are some simple things you can do to stop the therapy cap:
Additional Resources
Archives—ASHA's previous advocacy efforts on the Medicare Therapy Cap Advocacy Campaign