| Providers in DC, DE, MD, NJ & PA | |
|
Year |
Deductible |
Co-insurance |
2021 |
1,484.00 |
$371.00 a day for days 61-90 $742.00 a day for days 91-150 (lifetime reserve days) $185.50 a day for skilled nursing facility days 21-100 |
2020 |
1,408.00 |
$352.00 a day for days 61-90 $704.00 a day for days 91-150 (lifetime reserve days) $176.00 a day for skilled nursing facility days 21-100 |
2019 |
1,364.00 |
$341.00 a day for days 61-90 $682.00 a day for days, 91-150 (lifetime reserve days) $170.50 a day for skilled nursing facility days 21-100 |
Year |
Deductible |
Co-insurance |
2021 |
203.00 |
20 percent of the Medicare allowed amount/fee schedule |
2020 |
$198.00 |
20 percent of the Medicare allowed amount/fee schedule |
2019 |
$185.00 |
20 percent of the Medicare allowed amount/fee schedule |
Year |
Therapy discipline |
Cap |
2021 |
PT/SLP |
$2,110.00 |
|
OT |
$2,110.00 |
2020 |
PT/SLP |
$2,080.00 |
|
OT |
$2,080.00 |
2019 |
PT/SLP |
$2,040.00 |
|
OT |
$2,040.00 | Section 50202 of the Bipartisan Budget Act of 2018 repeals the application of the therapy caps while also retaining and adding limitations to ensure appropriate therapy. A provision of section 50202 of the BBA of 2018 adds section 1833(g)(7)(A) of the Act to preserve the former therapy cap amounts as thresholds above which claims must include the KX modifier to confirm that services are medically necessary as justified by appropriate documentation in the medical record. These amounts are now known as the KX modifier thresholds. The Part A deductible/coinsurance amounts and Part B deductible amounts for previous years can be found in the CMS IOM Pub. 100-01, General Information, Eligibility and Entitlement Manual, Chapter 3, Sections 10.3 & 20.2.
|
 | |