Is There a 2-Tiered Therapy Threshold for Medicare?
Ever since the Centers for Medicare and Medicaid Services (CMS) implemented the Targeted Medical Review process, providers of outpatient therapy services have referred to this as the “second cap”, the “second tier”, or the “second threshold” with the “first cap” or “first tier” being the annual therapy threshold (formerly called the therapy cap). In this article, I will answer common questions I receive on the annual therapy threshold and the targeted medical review and provide criteria on how claims may be selected for a targeted medical review. QuestionWhat is annual therapy threshold dollar amount for calendar year 2021? Answer QuestionIn