10/28/15
CMS Updates Therapy Cap Exception Process
The Centers for Medicare and Medicaid Services (CMS) has issued updated policies concerning exceptions to the annual therapy caps due to medical necessity. These policies will only apply when the exceptions process is in effect. CMS reiterates that a Medicare beneficiary may qualify for use of the cap exceptions process at any time during the episode when documented medically necessary services exceed caps. All covered and medically necessary services qualify for exceptions to caps. There are no longer diagnosis codes that automatically qualify a Medicare beneficiary for an exception to the annual therapy cap dollar threshold. This has been true
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