MedPAC recommends lowering outpatient therapy caps by 33%

Share this article:
MedPAC recommends lowering outpatient therapy caps by 33%
MedPAC recommends lowering outpatient therapy caps by 33%

Already contentious Medicare Outpatient Part B therapy caps would likely receive even more attention if the Medicare Payment Advisory Commission has its way. MedPAC recommended Thursday that Congress drop the annual allowable limits from $1,880 to $1,270.

The group voted unanimously to reform the caps, one of which is for occupational therapy, and the other is for physical and speech-language therapy combined. Most skilled nursing residents are currently shielded from the caps under an umbrella exceptions process, but that provision is set to expire at the end of the year.

MedPAC also recommended the introduction of a manual medical review process for all requests that exceed one of the caps; permanently including services delivered in hospital outpatient departments under the caps; and reducing the practice expense payment by half when multiple therapies are provided to the same patient on the same day.

The commission said the changes would ensure the program “integrity” of outpatient therapy services and ensure access to outpatient therapy services in the longer term.

MedPAC is required by the Affordable Care Act to report recommendations for outpatient therapy changes to Congress by June 15, 2013.

For more on MedPAC's recommendations, see the slide presentation attached above.

Share this article:

More in News

A small team of workers responds best in emergencies, expert says

A small team of workers responds best in ...

Long-term care providers should consider a "flat" crisis management approach that relies on a core group of staff members, experts advised Wednesday at the LeadingAge annual conference.

Nursing homes have better pain and catheter management if leaders have more ...

Nursing homes led by administrators and directors of nursing with higher levels of education and certification have better outcomes on some key quality measures, according to recently published findings.

Court green-lights charges that a healthcare network underused observation stays

A whistleblower can continue to pursue charges that a Nevada healthcare network routinely admitted people as hospital inpatients when they should have been placed in observation status, a federal appeals court recently ruled.