2012 Outpatient Therapy Caps and Exclusions

The cap for outpatient physical therapy and speech language pathology limit has increased to an incurred limit expense of $1,880.00. The outpatient occupational therapy limit is limited to $1,880.00 as well. TPTCCA also extends the exceptions process for outpatient therapy caps.  Outpatient therapy service providers may continue to submit claims with the KX modifier, when an exception is appropriate, for services furnished on or after January 1, 2012, through February 29, 2012.