WebPT EMR | Medicare Threshold Report

Overview

Even though the Medicare Cap has officially been repealed as of February 9, 2018, PTs, SLPs, and OTs are still expected to apply the KX modifier to claims over the following threshold amounts for 2024:

$2,330 for PT and SLP services combined, and

$2,330 for OT services

Use the WebPT EMR Medicare Allowable Threshold Report to view all your Medicare patients’ progress toward this dollar amount and ensure the KX modifier is applied accurately.

You will first need to set up your Medicare Fee Schedule to use the Medicare Threshold Report and turn on the Medicare Threshold Alerts.

When you generate the Medicare Threshold Report, you’ll immediately see all Medicare patients progressing toward the therapy threshold for this calendar year. The report will display with:

Patient Name

Last Date of Service

The amount of the therapy threshold used vs. the amount remaining or exceeding

Prior therapy threshold amount used

Case name

Whether a therapist has applied the KX modifier

Therapist type

Therapist initials

Click the arrow or colorblock below to discover more.

Run and narrow Report results

EMR_Reports_Medicare Threshold Report

Click on Medicare Threshold from the Reports menu on the left-hand side of the Dashboard to access the Medicare Threshold Report.
Choose the year using the Time Period drop-down menu.
Type the first or last name in the Patient filter then select it from the list, and click Generate Report. You can see the specific patient's overall, current, and previous therapy threshold totals.
Choose the provider specialty, using the Therapist Type drop-down menu.
Select Yes to include KX modifiers or No to exclude KX modifiers from the drop-downs.
Click Generate Report, to apply the filters to your report.
You can Export to Excel or Generate a PDF of the report results.
Click any patient name to access that patient’s record.

WebPT EMR | Medicare Threshold Report

Overview

What's Next