What is the “Therapy Cap”?
Under the Balanced Budget Act (BBA) of 1997 Congress placed an annual cap on rehabilitation services under Medicare. The therapy cap amount for 2017 is $1,980 for outpatient physical therapist and speech-language pathology services combined. There is a separate $1,980 cap for outpatient occupational therapy services. See FAQs about the cap.
According to APTA, without an exceptions process for the Medicare therapy cap, some 1 million beneficiaries each year are left without Medicare coverage for medically necessary services. This includes those who need multiple therapies after a stroke, traumatic brain injury, spinal cord injury, hip fracture, and other catastrophic injuries. It also denies those with Parkinson disease, multiple sclerosis, and arthritis the ability to effectively manage their conditions. Now is the time to permanently repeal it.
See below for ways to get involved:
- Participate in Therapy Cap Social Media Campaign (July 24-29, 2017).
- Email your legislators.
- APTA has provided prewritten letters for APTA members on the Legislative Action Center and for nonmembers/patients on the Patient Action Center. You can also send letters through the APTA Action App.
- Find our elected officials via ASHA’s Take Action website.
- Visit AOTA’s Legislative Action page to get tips on writing letters, who to contact, and more!
- Meet with your legislators. Schedule a district meeting, attend a town hall event, or invite your legislators to visit your practice over recess. This is a great opportunity to meet with your members of Congress locally and discuss the importance of repealing the therapy cap.
- Receive Email Updates and Stay Informed.
- Join the PTeam to receive email updates on the latest therapy cap news and receive alerts when it is time to take action and contact your members of Congress on these reform policies.
- Subscribe on ASHA’s Take Action website to receive updates.
- Visit AOTA’s Legislative Alerts and Actions Page for updates.
WHAT DO ASHA, AOTA, AND APTA HAVE TO SAY?
On July 25th, representatives of ASHA, AOTA, and APTA asked Congress to repeal the Medicare therapy caps, which have a disproportionate impact on older, more chronically ill beneficiaries from underserved areas. View their comments HERE.