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Removal of Service Limits: Physical Therapy, Occupational Therapy, and Speech Therapy

Posted Jan 28, 2021

Learn more about which plans are affected

Starting January 1, 2021, Healthfirst will remove service limits on physical therapy (PT), occupational therapy (OT), and speech therapy (ST).
Please note Healthfirst still requires prior authorization and will cover medically necessary PT, OT, and ST visits that are ordered by a doctor or other licensed professional.

This applies to the following plans:

  • Medicaid Managed Care (MMC) plans, including Mainstream MMC plans, HIV Special Needs Plans (HIV SNPs), and Health and Recovery Plans (HARPs)
  • Senior Health Partners, Managed Long Term Care Plan
  • Essential Plan 3
  • Essential Plan 4

Note: CompleteCare members do not have therapy limits since these visits are covered by Medicare.

Should you have any questions, you may contact your network representative, or call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am–5:30pm.

View this alert here.