Therapy Caps: Yes, You Still Have The Therapy Cap Exceptions Process

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains how Medicare outpatient therapy payment caps were affected by MACRA and why the therapy cap exceptions process remained in place after the legislation. It summarizes reactions from stakeholder organizations and discusses the broader policy and advocacy context for therapy reimbursement. The piece is relevant to providers, coders, compliance staff, and reimbursement professionals who follow Medicare therapy payment rules and legislative updates.

Why This Topic Matters

Changes to Medicare outpatient therapy cap policy can affect access to care, reimbursement planning, and whether claims may require use of the exceptions process. Understanding the legislative status and advocacy landscape helps healthcare organizations track payment policy changes that may influence therapy services.

What You Will Learn

  • How MACRA affected Medicare outpatient therapy cap policy
  • What happened to the therapy cap exceptions process after the legislation
  • How stakeholder organizations responded to the policy outcome
  • Why therapy payment policy remains a concern for providers and patients

Who Should Read This

  • Medical coders
  • Billing professionals
  • Revenue cycle staff
  • Compliance professionals
  • Therapy providers
  • Practice administrators

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