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."