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Alert - Medicare Part B Fee Screens Now Available

​The American Taxpayer Relief Act of 2012 passed on Jan. 1, 2013. While it was primarily intended to stop automatic tax increases and federal spending cuts, several provisions pertained to the Medicare program. By postponing sequestration cuts until March 1, 2013, the Act delayed a potential two percent reduction in payments to Medicare providers.  The Act also delayed the planned cut in Medicare reimbursement for all services paid by the Physician Fee Schedule, including outpatient therapy services. The announced spending cut for payments was to be 26.5 percent in 2013. Under the legislation, the conversion factor is set at zero, meaning payments will remain relatively unchanged for 2013. 

Therapy Cap Exception Process

The American Taxpayer Relief Act of 2012 extended the therapy cap exception process to Dec. 31, 2013. The therapy cap is extended to hospital outpatient settings as well as to therapy furnished as part of outpatient critical access hospital services through Dec. 31, 2013. The Manual Medical Review process is also extended through Dec. 31, 2013 for claims at or above $3,700 for physical therapy and speech therapy combined and $3,700 for occupational therapy.

A good reference is the CMS therapy cap fact sheet available at cms.gov.

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Jeff Heaphy

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