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An expansion of plan of care requirements for patients covered by UnitedHealthcare has caught the attention of APTA and many PTs across the country, and for good reason — its requirement for additional signoffs for physical therapist services presents a new and potentially burdensome administrative hoop.

While an initial authorization for physical therapy has always required a plan of care, soon the referring provider or appropriate specialist will be required to sign and date it. This policy applies to UHC Commercial benefit plans in all states as well as individual exchange benefit plans in all states except Colorado, Massachusetts, Nevada, and New York. UHC states that the updated policies were adopted in April. In addition to the signed plan of care requirement, all treatment session notes must include the "start and stop time in treatment." The change can be found beginning on Page 20 of this UHC policy update bulletin.

While commercial payers rarely seek input on proposed changes, APTA works to maintain communications and provide feedback with insurers whenever possible. In this instance, APTA expressed concerns to UHC, along with questions on how and when the policy will be implemented. This is a top priority for the association's Health Policy and Payment Department, and APTA will share updates as they become available. Questions can be sent to

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