Medicare Continues Pay Cap On Speech, Occupational Therapy In 2018

Medicare payments for occupational and speech-language pathology (SLP) therapy services will continue to be capped in 2018. This is due to Congressional inaction.

This Congressional inaction is a disappointment to therapy providers, especially since Congress had discussed an alternate system in late October. The alternate payment system was supported by the American Physical Therapy Association (APTA) , the American Occupational Therapy Association (AOTA) and others. The new suggested system would have scrapped the therapy cap and instituted a system of Medicare extenders in its place, but Congress failed to act.  Consequently, therapists could be limited to the 2018 therapy cap with no way to provide additional care in special circumstances. this would especially hurt senior citizens.

Medicare: What Happens Now?

Congress’ inaction creates the worst-case scenario for patients and providers. Medicare patients will start the new year unsure if they will receive medically necessary care, according to American Physical Therapy Association.

Congress returns from the winter recess on January 19. Therapy associations hope legislators will make the therapy cap discussion an early priority, and repeal the therapy cap.

Meanwhile, therapy providers await guidance from the Centers for Medicare & Medicaid Services (CMS) on therapy cap implementation for 2018 in lieu of any congressional solution.