The Centers for Medicare & Medicaid Services (CMS) will immediately release for processing therapy claims that have been held that contain the KX modifier with dates of receipt of Jan.1-10.
CMS will also implement a “rolling hold” to minimize the impact of legislation to extend the outpatient therapy caps, if the exceptions process is enacted.
The current outpatient therapy cap is $2,010 per year for physical therapy and speech/language pathology combined, and $2,010 per year for occupational therapy. If the exceptions process is not enacted, beneficiaries whose therapy exceeds these caps will be responsible for payment.
