Help Medicare Beneficiaries Improve Access to Physical Therapy

The US Congress failed to act to extend the Medicare exceptions process for physical therapy prior to December 31, 2017.  As a result, a hard cap of $2010 will be in place for all Medicare Part B beneficiaries for COMBINED physical therapy and speech therapy.  At around $100 per visit, that is a limit of around 20 visits per year.  For most situations, this is fine but consider the following cases: 

  1. Jack has a total knee replacement in January and requires 16 visits of physical therapy (2x/week x 8 weeks).  In October he falls and breaks his arm.  His doctor orders more physical therapy to help him regain use of his arm.  Even though further therapy is medically necessary, Jack has only about 4 visits to rehab this condition.  Any further visits would have to be paid for out-of-pocket.
  2. Sally has a stroke and has long-lasting right sided  hand paralysis as well as speech difficulties.  She completes her inpatient rehab under Medicare Part A and then is referred to outpatient physical therapy and speech therapy under Part B.  Sally now only has $2010 to spend on BOTH her physical therapy and speech therapy COMBINED.

In prior years, congress has passed an exceptions process in which patients in complex situations such as Jack and Sally would be able to have additional medically necessary care paid for.  Effective January 1, 2018 though, this is no longer the case.  There will be a $2010 limit on all outpatient physical and speech therapy with NO EXCEPTIONS!

You can make a difference!

Follow this link to contact your representatives in congress and ask them to repeal the hard cap on physical therapy.  Whether you are a medicare beneficiary yourself, or perhaps you have parents, friends, or neighbors who are Medicare beneficiaries, ACT NOW to help them gain access to medically necessary care that they have paid for their entire working lives!

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