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Medicare Part B Therapy Cap Exceptions Process

The Centers for Medicare and Medicaid Services (CMS) has provided detailed documentation requirements for the exceptions process. The following provides speech-language pathologists with relevant information on the exceptions process and documentation requirements. Please note that Medicare does not accept manual exceptions process requests; all requests should be submitted via the automatic exceptions process. 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.