CommercialPrior AuthHigh impact
Prior Authorization Request - Physical, Occupational, and Speech Therapies
Healthfirst·Physical Therapy, Occupational Therapy, PM&R (Physical Medicine & Rehab) +4 more·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Healthfirst now requires prior authorization for outpatient physical therapy, occupational therapy, and speech therapy services effective January 1, 2024. Providers must submit requests using a new fax form or online portal, including clinical documentation for all therapy services.
Action Required
Immediately: All staff must implement prior authorization requirements for Healthfirst members receiving PT, OT, or ST services. Billing team must update system to flag these services for prior auth. Front desk staff must verify authorization before scheduling. Providers must complete new fax form with clinical documentation and submit to 1-646-313-4603 or use online portal at hfproviderportal.org. Claims will be denied without proper prior authorization.