03/05/18
Medicare Therapy Cap & Use of the ABN
Since passage of the 2018 Bipartisan Budget Act of 2018 that repealed the therapy cap for outpatient therapy services, I have been receiving many questions about the application of the KX modifier for services that exceed either $2010 or $3000 physical therapy and speech therapy combined in 2018 or a separate $2010 or $3000 for occupational therapy. Most of the questions center around should I provide the Medicare beneficiary with an advance beneficiary notice of noncoverage (ABN) when they exceed either $2010 or $3000 in calendar year 2018? In this article, I will answer the following questions: If the therapy
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