Therapy Cap Exception

April 3, 2011

The Therapy Cap Exception process has been extended for 2011.  There is a dollar tracking feature in Misys that can track the Medicare allowable and assist you in notifying your patients when their therapy limit for 2011 has been reached.  The Therapy Cap limit for 2011 is $1870.  To use this feature reliably, you should begin in January (as Therapy Caps are annual) and you must know if the patient has received any services with other providers within the calendar year.  Please notify our office if you want to utilize this feature.  As audits are increasing, be sure your documentation supports the medical necessity to continue treatment beyond the therapy cap when you choose to apply the KX modifier.