Skip to main content

Advocacy by APTA has brought changes to UnitedHealthcare policies that will somewhat ease burdensome prior authorization requirements in certain Medicare Advantage plans for PT treatment visits following an initial evaluation when services are provided in office and outpatient hospital settings. APTA recognized the change as a step in the right direction but one that hasn’t gone far enough.

As of Jan. 13, UHC allows up to six follow-up visits after an initial evaluation without requiring a clinical review. Previously, a clinical review was required before any follow-up visits could occur, which APTA strongly argued would delay needed services and hinder effective care. In announcing the change, UHC said that "based on feedback from providers, UnitedHealthcare has updated the prior authorization requirement for physical, speech, and occupational therapy and chiropractic services that became effective Sept. 1, 2024, for UnitedHealthcare Medicare Advantage individual and group retiree members."

Log in or create a free account to keep reading.


Join APTA to get unlimited access to content.


You Might Also Like...

Article

APTA Medicaid Advocacy: State Wins and Updated Medicaid Payment Resource

May 21, 2025

APTA chapters are fighting to change Medicaid policy to improve payment and access to PT services in their states.

Article

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

May 20, 2025

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

Article

‘Shark Tank’ Winner to Keynote at APTA Future of Rehab Therapy Summit

May 13, 2025

Dan Staats, PT, DPT, shares how clinical curiosity sparked a business — and what every attendee can learn from his entrepreneurial journey.