Medicare Part B Outpatient Therapy–Know Your Limits

Many clients receive outpatient therapy; perhaps for a hip replacement, stroke, or some other treatment. While Medicare does offer coverage for this kind of treatment, there are limitations of which you need to be aware.  Medicare places caps on these services when you receive them from outpatient providers. Remember, Medicare also requires these treatments to be medically necessary. Copayment and payments made to providers can be applied toward the cap.

Here are the caps:

• Physical Therapy and Speech Therapy-$1,940
• Occupational Therapy - $1,940

Medicare allows providers to receive payments above the cap amount as long as the provider documents the need for the medical necessary services, and it also must be noted on the billing statement. After you pay your yearly deductible for Medicare Part B (Medical Insurance), Medicare pays its share (80%), and you pay your share (20%) of the cost for the therapy services.

Call us today for more information regarding Medicare open enrollment.