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Therapy Cap Update as of January 23, 2018

The United States Senate and House of Representatives have passed legislation to fund the federal government until February 8, 2018 and fund the Children’s Health Insurance Program for 6 years. President Trump signed the bill Monday evening. Unfortunately, the legislation had no language in it regarding the therapy cap, repeal of the therapy cap and/or extension of the therapy cap process for calendar year 2018. So what does this mean for Medicare beneficiaries receiving outpatient therapy services?

Currently, there is a hard therapy cap of $2010 for physical therapy and speech-language pathology services combined and a separate $2010 for occupational therapy. There is no therapy cap

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Billing CPT Code 92507 on Same Day as CPT Code 97127

A question I receive is can a speech-language pathologist (SLP) bill CPT code 92507 (treatment of speech, language, voice, communication, and/or auditory processing disorder, individual) or CPT code 92508 (treatment of speech, language, voice, communication, and/or auditory processing disorder, group) on the same day they also bill CPT code 97127 – therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing and sequencing tasks), direct (one-on-one) patient contact? To simplify the question, can an SLP bill 92507 and/or 92508 and 97127 on the same day for a patient who has Medicare as their insurance? The answer might surprise you!

According to the National Correct Coding Initiative (NCCI)

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Billing CPT Code 92507 Same Day as CPT Code 97533

A question I receive is can a speech-language pathologist (SLP) bill CPT code 92507 (treatment of speech, language, voice, communication, and/or auditory processing disorder, individual) or CPT code 92508 (treatment of speech, language, voice, communication, and/or auditory processing disorder, group) on the same day they also bill CPT code 97533 (sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands)? To simplify the question, can an SLP bill 92507 and/or 92508 and 97533 on the same day for a patient who has Medicare as their insurance? The answer might surprise you!

According to the 2018 National Correct Coding Initiative (NCCI)

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