The Medicare Therapy Cap…YOU Can Make a Difference!


Medicare benefits for speech therapy are in danger of becoming limited by arbitrary financial limits unless Congress takes action.  This could result in many seniors not being able to receive all the therapy they need even when they have the potential to make additional progress.

Speech pathologists, physical therapists, and occupational therapists are lobbying Congress to make sure that therapy services remain appropriately covered by Medicare for the patients who need them.  As Congress continues its attempts to rein in Medicare costs, it is important that clinicians and patients join in the fight and let our voices be heard on Capitol Hill!  You can help protect therapy benefits by telling your local U.S. Congressmen and U.S. Senators to pass legislation to extend the Medicare therapy cap exceptions process beyond December 31, 2011.


The Medicare therapy cap is a financial limit that has been placed on the amount of therapy services Medicare will cover. In 2011, it caps coverage of outpatient rehabilitation services to $1,870 for physical therapy and speech therapy services combined. Not all patients will exceed the cap, but Medicare beneficiaries who suffer from a stroke, have Parkinson’s disease, or multiples instances of care are very likely to need more treatment than the cap permits.

Congress has recognized the problem with the cap on therapy services in the past. Since the therapy caps were passed by Congress in the Balanced Budget Act of 1997, Congress has passed several moratoriums which allow patients to exceed the cap if ongoing progress can be documented in therapy.   If the exceptions process is not extended or completely repealed then patients will be denied services when this financial limit has been reached.

It is important that we send a strong message to our Members of Congress and request that they pass legislation to extend the Medicare therapy cap exceptions process beyond December 31, 2011.

Action couldn’t be easier….

  • Call your Members of Congress.   You can find out who your current Members of Congress are and their phone numbers online.
    • Ask your member of congress to sign onto the Medicare Access to Rehabilitation Services Act of 2011 (H.R. 1546/S. 829) which repeals the cap once and for all.
  •  Utilize the American Speech Language Hearing Association (ASHA) action center to send an email message to your Members of Congress.     All you have to do is enter your name and address, and the website will automatically send the message to your Members of Congress.
This is democracy in action so make sure your voice is heard!
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Author: Jennifer Carter

Jen is a Denver speech pathologist that specializes in providing treatment for swallowing difficulty (called dysphagia). She has provided speech therapy to patients for 18 years and opened the Carter Swallowing Center because of her passion for helping patients recover from swallowing problems.

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