As of right now, there is no exception process for therapy billing when the patient is over the 2018 cap of $2010. This cap is for PT & ST combined, and then that amount for OT. Congress has not passed anything to allow any KX to be used on our claims. All must keep up on this as many of our residents are receiving therapy that is over the caps by the billers applying the KX modifier.
https://www.cms.gov/Medicare/Billing/TherapyServices/index.html
