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What are some exceptions to the Part B therapy cap?

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Final answer:

There are three exceptions to the Part B therapy cap: medical review exception, chronic conditions, and Medicare outpatient exceptions process.

Step-by-step explanation:

Under the Part B therapy cap, there are some exceptions that allow beneficiaries to receive additional therapy services beyond the cap limit:

  1. Medical Review Exception: In cases where a beneficiary's condition justifies the need for additional therapy services, Medicare may grant exceptions. The medical review process evaluates the medical necessity and appropriateness of the therapy services.
  2. Chronic Conditions: Beneficiaries with chronic conditions such as multiple sclerosis or Parkinson's disease may qualify for an exception to the therapy cap limit.
  3. Medicare Outpatient Exceptions Process: The Medicare Outpatient Exceptions Process allows beneficiaries to seek an exception to the therapy cap when they exceed the annual therapy cap limit and can demonstrate that the services are medically necessary.
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