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AETNA clarifies no prescription for PT needed in direct access states

Monday, October 8, 2018   (0 Comments)
Posted by: Matthew Nicholas
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AETNA clarifies no prescription for PT needed in direct access states

Aetna’s policy reads that “Aetna considers physical therapy medically necessary when this care is prescribed by a chiropractor, DO, MD, nurse practitioner, podiatrist or other health professional qualified to prescribe physical therapy according to state law." The APTA reported this week that representatives from Aetna provided clarification that, in states with direct access provisions for PTs, a PT is considered an “other health professional qualified to prescribe physical therapy,” which means that PT services will be reimbursed without an order or referral if all other requirements are met.  

It is important to still verify coverage benefits and requirements for new patients, as some plan designs require precertification and others may have a limit to the number of visits allowed.  

10/08/2018


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