2006 proposed fee schedule - American Society of Clinical Oncology

K. Therapy Cap
73223 MRI joint upper extr w/o & w/dye
Family 11 CT and CTA (upper extremities)
73200 CT upper extremity w/o dye
73201 CT upper extremity w/dye
73202 CT upper extremity w/o & w/dye
73206 CTA upper extr w/o & w/dye
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[If you choose to comment on issues in this section, please
include the caption “THERAPY CAP” at the beginning of your
comments.]
Section 1833(g)(1) of the Act applies an annual, per
beneficiary combined cap on outpatient physical therapy (PT)
and speech-language pathology services, and a similar
separate cap on outpatient occupational therapy services
under Medicare Part B. This cap was added by section 4541
of the BBA 1997, Pub. L. 105-33. However, the application
of the caps was suspended from CY 2000 through CY 2002 under
section 1833(g)(4) of the Act by section 221 of the of
BBRA 1999, Pub. L. 106-113, and extended by section 421 of
BIPA 2000, Pub. L. 105-551. The caps were implemented from
September 1, 2003 through December 7, 2003. Section 624 of
the MMA reinstated the moratorium on the application of
these caps from December 8, 2003 through December 31, 2005.