Medicare AdvantageReimbursementHigh impact
New Effective Date for Acupuncture, Occupational Therapy, Physical Therapy, and Speech Therapy Standard Fee Schedule Rates
Healthfirst·Physical Therapy, Occupational Therapy, PM&R (Physical Medicine & Rehab)·Reimbursement
Effective date
Jun 1, 2024
We identified it
Jun 20, 2026
Summary
Healthfirst is switching from fee-for-service billing to per diem rates for acupuncture, occupational therapy, physical therapy, and speech therapy services. The implementation has been delayed from April 1, 2024 to June 1, 2024.
Action Required
Before June 1, 2024: Billing team must update system to accommodate per diem billing instead of individual CPT codes for acupuncture, occupational therapy, physical therapy, and speech therapy services with Healthfirst. Contact DSEProviderRaterequests@healthfirst.org with TIN and specialty or call 1-888-801-1660 to clarify new per diem rates and billing procedures. Update billing software and train staff on new reimbursement methodology.