For instance, if a person suffered a leg injury earlier this year and completed several weeks of physical or occupational therapy as an outpatient at an area hospital, that person may be approaching his or her therapy cap.
If that same person were to suffer another injury today, hospital therapists could determine how close the patient is to the cap and whether the new injury qualifies for the exemption.
“People are guaranteed payment by Medicare for that evaluation,” Meister said. “In order for us to help the patient, we need to make that initial evaluation.
“It all has to do with what would be the impact if a person did not have therapy,” she added. “Would it have a negative impact on the person’s ability to perform normal daily activities.”
The therapy cap is for services provided in 2012. Meister does not know if the cap will continue in 2013 but noted that Medicare continues to look for ways to reduce the costs of providing health care.
Email Jeff Meyers: firstname.lastname@example.org
TO LEARN MORE
For more information on the new Medicare caps for outpatient therapy at hospitals, visit www.medicare.gov/contracts or call (800) 633-4227.
Personal Medicare information can also be accessed through Medicare's secure server at www.MyMedicare.gov. Rehab patients at CVPH can call 562-4616 for more information.