Act Now: Urge Congress to Immediately Repeal the Medicare Part B Outpatient Therapy Caps

Members & Publications


January 12, 2018

On January 1, 2018, therapy cap restrictions on Medicare Part B outpatient services went into effect, after a December 31 expiration of the current exceptions process. The Medicare therapy cap is an annual limit on per-patient therapy expenditures under Part B. As a result, many of your patients are now at risk of losing access to this critical care. Congress must act immediately to prioritize therapy cap repeal to avoid denials of crucial therapy services and disruption of patient care.
In October 2017, the House and Senate reached a bi-partisan policy agreement that would permanently repeal therapy caps, but failed to act before the recess to enact vital legislation. Under the current policy, Medicare beneficiaries cannot receive outpatient occupational therapy services, and, separately, physical therapy and speech language pathology services combined, if those services would exceed the "cap" amount, regardless of medical need.
Your Academy has long advocated for full repeal of the arbitrary therapy caps that harm beneficiaries most in need of these services. Congress must understand that these caps will inhibit Medicare beneficiaries' ability to get proper care for the appropriate duration of time, and limitations on this critical care reduces the patient's opportunity to maximize their function and to improve their quality of life.
Please take a moment to send a customizable email to your members of Congress today, urging that they immediately act to permanently repeal the therapy cap.

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Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.