Billing Above the Therapy Cap

May 18, 2015
Rick Gawenda

I often receive this question from people around the United States. The Medicare beneficiary has exceeded their annual therapy cap dollar threshold and they have a secondary insurance that will pay for therapy above the cap, how do I get the Medicare program to deny so that I can bill the secondary? Here is my usual response to this question. If the therapist feels the therapy they are providing is

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