MedicaidCoverageMedium impact
Removal of Service Limits: Physical Therapy, Occupational Therapy, and Speech Therapy
Healthfirst·Physical Therapy, Occupational Therapy, PM&R (Physical Medicine & Rehab)·Provider Update
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Healthfirst has removed service limits on physical therapy, occupational therapy, and speech therapy visits effective January 1, 2021. Prior authorization is still required, but there are no longer caps on the number of medically necessary therapy visits.
Action Required
Immediately: Billing team should update internal guidelines to reflect unlimited therapy visits for eligible Healthfirst plans while maintaining prior authorization requirements. Verify patient eligibility for MMC, HIV SNPs, HARPs, Senior Health Partners, Essential Plan 3, and Essential Plan 4. Note that CompleteCare members continue to have Medicare coverage without therapy limits.