Medicare & Rehab
True or False: Medicare has a therapy cap that limits the number of therapy visits a beneficiary can receive each year.
False.
Beneficiaries can continue to receive medically necessary therapy services beyond the annual payment threshold. However, providers must use the KX modifier once annual thresholds are exceeded.
Which player is known as King James?
What root vegetable was originally carved into jack-o'-lanterns before pumpkins became popular?
Turnips
What Starbucks beverage is often considered the unofficial start of fall?
Pumpkin Spice Latte
For Medicare Part B therapy services in 2026, what happens when a patient exceeds the annual therapy threshold?
A. Therapy must stop
B. A physician must re-certify immediately
C. The KX modifier must be applied if services remain medically necessary
D. The patient automatically becomes self-pay
C. The KX modifier is required to attest that services remain medically necessary and are supported by documentation.
Who is the greatest player of all time, known by the nickname of "Air"?
Michael Jordan
What is the name of the friendly ghost in cartoons and movies?
Casper
Yesterday was the first day of fall. What astronomical event marks the first day of fall.
The autumnal equinox
What is the 2026 Medicare KX threshold for PT and SLP services combined, and OT services alone?
$2,480.
Which player is known as "The Round Mound of Rebound"?
Charles Barkley
According to folklore, what creature can be killed with a silver bullet?
Werewolf
What green pigment do leaves lose that results in fall color change?
Chlorophyll
What happens when a Medicare beneficiary has exceeded the secondary threshold of $3,000 for PT/SLP or OT services?
Once claims exceed that threshold, they become eligible for targeted medical review.
Which player once scored 100 points in one game?
Wilt Chamberlain
Which classic monster was created by author Mary Shelley?
Frankenstein's monster
What nut is commonly collected by squirrels and other animals from oak trees in the fall?
Acorn
What year was the Medicare therapy cap officially repealed?
2018.
The Bipartisan Budget Act was signed into law on February 9, 2018.
Which team has won the most NBA championships?
Boston Celtics
Which midwestern U.S. state produces the most pumpkins?
Illinois
Apples are traditionally picked in orchards during the fall. What Michigan city is known as the "Apple Capital of the World"?
Sparta