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CMS-1403-FC
services, and a similar separate cap on outpatient
occupational therapy services. These caps apply to
expenses incurred for the respective therapy services under
Medicare Part B, with the exception of outpatient hospital
services.
The exceptions process for the therapy caps,
originally authorized by section 5107 of the DRA, was
extended from January 1, 2006 through December 31, 2007 by
section 201 of the MIEA-TRHCA. Section 105 of the MMSEA
provided for a further extension of this exceptions process
through the first 6 months of CY 2008 (that is,
January 1, 2008 through June 30, 2008).
2. MIPPA Provision for Cap Exceptions.
Section 141 of the MIPPA extends the exceptions
process for therapy caps from July 1, 2008 through December
31, 2009.
Section 1833(g)(2) of the Act provides that, for
CY 1999 through CY 2001, the caps were $1500, and for the
calendar years after 2001, the caps are equal to the
preceding year’s cap increased by the percentage increase
in the Medicare Economic Index (MEI) (except that if an
increase for a year is not a multiple of $10, it is rounded
to the nearest multiple of $10). The annual, per
beneficiary therapy cap for 2009 will be $1840 for physical
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