Many of your readers may be unaware that a hard cap on all Medicare beneficiary’s Physical, Occupational, and Speech Therapy care went into effect on January 1, 2010. I am referring to the financial limit on the amount of therapy care that Medicare will cover in a calendar year, often referred to as the "Medicare Therapy Cap". Curently there is a cap totaling $1860 per patient, PER YEAR for Physical and Speech Therapies combined, and up to $1860 per patient, PER YEAR for Occupational Therapy. In years past, there has been an "exception" to the therapy cap for patients in dire need of therapy care.
Starting on New Year’s Day, every beneficiary, regardless of his/her condition or medical history, is limited to $1860 of Physical or Speech Pathology services, and up to $1860 for Occupational Therapy services. Any Medicare patient who is coping with a chronic condition, or is recovering from a stroke or other debilitating illness, knows that $1860 is hopelessly inadequate in covering the extensive Physical, Occupational, and Speech Therapy services that those situations can require. Any Medicare beneficiary who is worried about having more than one injury or illness that requires therapy care during the year will face having to "ration" his/her already limited benefits to avoid having to pay out-of-pocket or going to a hospital outpatient department if additional care is needed.
Congress can do something to protect beneficiaries from losing their Medicare coverage!!! They can pass legislation this year (H.R. 43 / S. 46) that repeals this arbitrary, ill-conceived policy once and for all! Congress needs to take action as soon as possible, as there are already some patients who are on the verge of meeting their $1860 cap for 2010. I urge anyone who has a family member who is receiving Medicare benefits, or who is relying on Medicare coverage themselves, to contact our members of Congress without delay and demand that they take immediate action to repeal the "Medicare Therapy Cap" once and for all!!!
Director of Rehab
Brady West Nursing & Rehab Center