News Release

Medicare Part B Cap Does Not Apply for Therapy Services at Mercy Medical Center

CLINTON, Iowa – There’s good news for individuals age 65 or older who purchase Medicare Part B benefits for medical and outpatient services when it comes to coverage for outpatient therapy services. If physical, occupational or speech therapy services are provided by Mercy Medical Center Outpatient Rehabilitation Department in Clinton, the coverage limits for Medicare beneficiaries do not apply.

For many individuals age 65 or older the benefits of Medicare Part B offer some relief from increasing health care costs as one grows older. Purchasing Medicare Part B is optional and requires a monthly premium. It covers certain medical and outpatient services, including physical occupational and speech therapy.

On January 1, after much Congressional debate, Deficit Reduction Omnibus Reconciliation Act went into effect limiting the amount of therapy services covered annually by Medicare Part B unless services are provided by a hospital-affiliated clinic. The plan limits Medicare beneficiaries to $1,740 of covered occupational therapy and the same amount of covered physical and speech therapy combined.

Bridget Sweenie, Director of Rehabilitation Services at Mercy Medical Center – Clinton, explains, “What this means is that unless therapy is provided from a hospital-affiliated rehabilitation department after the first $1,740 per patient, per year, the patient will be required to pay for any and all additional services.”

The agreement does modify the Medicare law to allow patients to apply for additional therapy services if their treatment is expected to exceed the cap. But Sweenie noted,” This process has not been clearly defined and could lead to patients having to switch therapy providers halfway through their rehabilitation if the additional services are not approved.”

Patients who prefer the same therapist throughout their treatment or those who don’t want to worry about their therapy being covered may call Mercy’s Rehabilitation Department at (563) 244-3580. Services are provided Monday through Friday from 7 a.m. to 5:30 p.m. by experienced and dedicated physical, occupational and speech therapists.

For more information on Medicare Part B caps, call Medicare at 1-800-MEDICARE or visit www.cms.hhs.gov.