Never use ABNs to circumvent Medicare's therapy caps: NEMBs inform patients about their responsibili-ties under the caps

Article Overview

This article explains the return of Medicare therapy caps and the notice processes providers use when patients reach those limits. It focuses on the distinction between the notice forms used for noncovered services versus services that are covered under certain conditions, along with operational considerations for outpatient therapy settings and carrier tools for checking cap status. The content is relevant to billing staff, coders, therapy providers, and practice managers who need to understand Medicare compliance and patient notification in therapy services.