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2023 Annual Update of Per-Beneficiary Threshold Amounts

The purpose of this Change Request (CR) is to update the annual per-beneficiary incurred expenses amounts now called the KX modifier thresholds and related policy for calendar year 2023. These amounts were previously associated with the financial limitation amounts that were more commonly referred to as “therapy caps,” before their application was repealed when the Bipartisan Budget Act of 2018 was signed into law. Information related to this recurring update notification can be found in Publication 100-04, Chapter 5, Section 10.

Download the Guidance Document


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 06, 2022

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.