Medicare provides coverage under Part B for various outpatient therapy services such as physical therapy (PT), occupational therapy (OT), and speech language therapy. These services must be furnished by qualified professionals under an established plan of care. Such therapy services are subject to co-insurance, deductibles and an annual financial limitations cap. Such therapy services are subject to co-insurance, deductibles and annual financial limitations.

View Beneficiary Therapy Accruals via Noridian Medicare Portal (NMP) and/or Interactive Voice Response (IVR).

Access the below related information from this page.

• Certifying Physician: Identify for Claim Processing
• Incident To Clarification for OPPS and CAH Outpatient
• Multiple Procedure Payment Reduction (MPPR) for Selected Therapy Services
• Outpatient Physical Therapy (OPT) Reciprocal Billing Arrangements and Fee-For-Time Compensation
• Outpatient Therapy Certification Plan of Care
• Outpatient Therapy Services and Advance Beneficiary Notice of Noncoverage (ABN) Use
• Per-Beneficiary KX Modifier Thresholds
• Rehabilitation Delivery Methods
• Related Latest Updates Articles
• Therapy Non-Payable HCPCS Codes

Resources

• CMS Annual Therapy Update
• CMS Functional Reporting
• CMS Internet Only Manual (IOM), Medicare Benefit Policy Manual, Publication 100-02, Chapter 15, Section 220 and 230 – Coverage for PT, OT and SLP
• CMS IOM, Medicare Claims Processing Manual, Publication 100-04, Chapter 5 – Billing Part B Outpatient Rehabilitation
• CMS Jimmo Settlement
• CMS Multiple Procedure Payment Reduction (MPPR)