All PlansPrior AuthMedium impact
Physical Therapy Authorization and Approval Guidance Effective January 31, 2026
Healthfirst·Physical Therapy, PM&R (Physical Medicine & Rehab), Orthopedics·Prior Authorization
Effective date
Jan 31, 2026
We identified it
Jun 20, 2026
Summary
New prior authorization requirements for physical therapy services take effect January 31, 2026. The policy establishes specific authorization and approval guidance that will impact PT billing and referral processes.
Action Required
Before January 31, 2026: Billing team must review and implement new prior authorization procedures for physical therapy services. Update billing system workflows to ensure PT authorization requirements are met before service delivery. Train staff on new approval processes to prevent claim denials.