Home Health & Hospice Week

Don't think Medicare therapy cap amounts for Part B therapy services are going away entirely, thanks to the Bipartisan Budget Act of 2018.

"With regard to payment for outpatient therapy services, the law repeals application of the Medicare outpatient therapy caps but retains the former cap amounts as a threshold above which claims must include the KX modifier," the Centers for Medicare & Medicaid Services says in a new message to providers. Providers will use the KX modifier as "a confirmation that services are medically necessary as justified by appropriate documentation in the medical record," CMS explains.

Plus: BBA 18 also "retains the targeted medical review process, but at a lower threshold amount," CMS adds.

Remember: Therapy caps apply to outpatient therapy services furnished under Part B, including those provided in the home, but not to therapy furnished under the home health benefit.