Navigating the Medicare coverage system can be challenging. The Parkinson’s Action Network (PAN) put together an overview of coverage as it relates to therapeutic care: physical, occupational, speech. Print their one-pagers and talk to your physician and therapist about what these standards mean for you.
• There is currently a combined $1,920 yearly coverage cap for physical therapy and speech-language therapy, and a separate $1,920 yearly cap for occupational therapy.
• In 2006, Congress created an exceptions process for services deemed medically necessary to serve Medicare beneficiaries who need therapy services beyond the cap. As of now, the exceptions process is available until March 2015.
PAN also encourages patients to be aware of changes to the Medicare improvement standard. As of January 2014, Medicare beneficiaries can no longer be denied coverage for physical, occupational and speech therapy solely based on lack of improvement.
For more information, visit www.parkinsonsaction.org/medicaretherapy.