Home | 4/30/2012 Issue | Article

CMS to include outpatient therapy in patients’ therapy cap calculations

Effective Apr 30, 2012
Published Apr 30, 2012

A change to the therapy cap calculation means more work for practices starting Oct. 1.

CMS will count therapy a patient received in a hospital outpatient department toward the cap, set in 2012 at $1,880 for occupational therapy and $1,880 for physical and speech therapies, said Stewart Streimer, director of CMS’s provider billing group during an April 17 call. CMS will not reprocess claims, but, starting Oct. 1 it will recalculate a patient’s services toward the therapy cap amount retroactive to Jan. 1, he said.


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