NJPTAid Newservice Item: Medicare Cap
As you or may not now be aware, President Bush signed Senate Bill 1932 into law on February 8. This law now authorizes the Centers for Medicare and Medicaid Services (CMS) to develop a new exception process for Medicare beneficiaries to apply for medially necessary therapy services if their treatment is expected to exceed the $1,740 cap in 2006. While this process has not been finalized, CMS has stated that they do soon as soon as possible.
We encourage you to keep up-to-date on this important development through monitoring of communications from APTA and our news items. It is unclear exactly how this exceptions process will work, although submitted ICD-9 codes are likely to play a significant role, along thorough documentation of medical necessity. We cannot emphasize too strongly, the importance of documenting functional loss, both for Medicare beneficiaries and all of your patients.
As soon as we are aware of more details on this process, we will communicate them to you.