CMS Update On Outpatient Therapy Claims

Posted: January 25, 2018

CMS has just announced that they have been holding all outpatient therapy claims since January 1 that go above the $2,010 cap. CMS is expected to begin processing those claims in the near future, but they have not yet provided a timeline. In addition, CMS has stated that providers should continue to submit claims with the KX modifier, even though the exceptions process is not in place, under the assumption that Congress will retroactively apply the permanently therapy cap fix. APTA issued a FAQ document earlier this month and they will be revising it this week based upon additional expected guidance from CMS; we will keep you appraised as we learn more.