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PowerPoint Presentation for Outpatient Therapy Caps The PowerPoint Presentation (see Downloads section below) was developed to explain the financial limitation on outpatient therapy services. The Social Security Act provides for a limit to services paid under Part B for outpatient therapy services, with the exception of services provided in outpatient hospitals. These slides were developed before the Deficit Reduction Act and are applicable to those providers, suppliers and beneficiaries who are subject to the caps and are not eligible for exception from the caps. Complete understanding of the policies that apply to outpatient therapy services requires consulting the manuals that describe Medicare policies and the local coverage determinations, or articles published by the local contractor who pays your Medicare claims. The most relevant manuals are the Medicare Benefit Policy Manual, chapter 15 sections 220 and 230, and the Medicare Claims Processing Manual, chapter 5 sections 10 and 20. Also important is the description of coverage in the Medicare Program Integrity Manual, chapter 3. These manuals are updated as soon as policies change. If the answers to your questions are not found in these manuals, the Medicare contractor who pays your Medicare claims is authorized to answer questions and provide education about both the Medicare manuals and their local policies. If you are unable to obtain the information you need from the contractor, contact one of the 10 Medicare Regional Offices closest to you.
Page Last Modified: 03/13/2008 11:34:51 AM
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