CHA News Article

ATRA Extends Therapy Cap Implementation

The American Taxpayer Relief Act (ATRA) of 2012, signed into law by President Obama last week, extends several provisions of the Middle Class Tax Relief and Job Creation Act of 2012 that impact therapy services provided by hospital outpatient departments (HOPDs). The ATRA effectively extends applying therapy caps to HOPDs through Dec. 31, 2013. Mandatory manual medical review for Part B therapy services, which became effective Oct. 1, 2012, for hospital and non-hospital therapy providers, is also extended through Dec. 31, 2013, as a result of the new law. 

Specifically, the therapy cap for 2013 is $1,900 for physical therapy and speech/language pathology services combined. There is a separate $1,900 cap for occupational therapy services. Manual medical review thresholds are $3,700 for physical therapy and speech/language pathology services combined, and $3,700 for occupational therapy. 

Part B therapy services provided in critical access hospitals (CAHs) will now be included in the beneficiary cap calculation. CHA is seeking additional clarification on applying therapy caps to services provided by CAHs. The ATRA also prevents a scheduled payment cut for Part B physician and other services, including therapy services. However, effective April 1, outpatient therapy services will be subject to a 50 percent multiple procedure payment reduction (MPPR), increased from the current MPPR of 25 percent.

For more information on the ATRA’s health care related provisions, see CHA’s summary of the new law at In addition, CHA will hold conference calls Jan. 11 — at 11:30 a.m. and 2 p.m.  — to provide member hospitals with additional analysis of the ATRA and its impact on hospitals. While the calls are complimentary, pre-registration is required. To participate, go to