UHC, Optum Tighten Prior Auth Rules for Follow-Up PT Visits Under Many MA Plans

(This article was updated on Dec. 4 from its initial publication on Aug. 19 to include additional clarifications and guidance from UHC.)

In disappointing moves that walk back needed reforms to burdensome prior authorization policies announced in August 2023, UnitedHealthcare has expanded prior authorization requirements within certain plans for follow-up PT visits when services are provided in office and outpatient hospital settings, effective Sept. 1.

See which plans are impacted and which are excluded.

Join APTA to get unlimited access to content.

Create a free account Log in

You Might Also Like...

Article

APTA Champions Return of Bill to Expand Access to Pelvic Health Physical Therapy

Jun 24, 2025

APTA and APTA Pelvic Health are advocating to improve access to vital postpartum care, including pelvic floor physical therapy. This persistence is paying

Article

APTA Advocacy Leads to Direct Access for Millions Covered by Aetna

Jun 17, 2025

The Big Picture of Aetna’s Policy Change In response to ongoing advocacy efforts by APTA, Aetna has updated its physical therapy policy to provide unrestricted

Article

APTA to CMS: It’s Time to Reduce Admin Burden and Simplify the Delivery of Care

Jun 16, 2025

The association has taken the lead on advocating for regulatory reforms and deregulation to improve the delivery of physical therapy.