Legislation is pending in Pennsylvania, Missouri, and New York for limiting the amount insurers can charge patients for physical, speech, and occupational therapy. South Dakota and Kentucky lawmakers have already passed laws regarding these measures.
Currently, therapy sessions with a physical, speech, or occupational therapist costs about the same as seeing a neurosurgeon or other specialists. The legislation would require insurance companies to only make patients pay co-payments about the same as a primary care physician.
Physical therapy is seen by insurance companies as specialty care, and visits can cost as much as $75 each. If a person has an injury or special need and must see the therapist regularly, these charges can really add up.
Nationally, co-payments for a primary care visit averages at about $22, whereas specialty visits average at $32. While the legislature will bring the co-payments for specialty visits down, critics say it will make insurance premiums rise. While the patient pays a co-payment, insurance companies are responsible for the rest of the bill — and most insurance companies don’t want this legislature to pass.
Most patients end up footing the bill for a majority of therapy visits for speech, occupational, or physical therapy, which typically results in them using only a few prescribed visits or not coming in for therapy at all.
Many people who need these therapies regularly support the legislature. If it’s affordable, these individuals can get the care they need.
Resource: Kaiser Health News
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