Utah has officially made history by becoming the first state in the U.S. to formally recognize physical therapists as primary care providers for neuromusculoskeletal conditions. With the passage of this groundbreaking legislation, physical therapists in Utah are now empowered to provide care as the first point of contact for patients suffering from conditions affecting the muscles, bones, and nervous system. This policy shift is a result of persistent advocacy efforts led by APTA Utah and marks a transformative moment in healthcare delivery.

What the New Law Means

Traditionally, patients needed a referral from a physician to receive physical therapy services under insurance. While direct access laws have existed in various forms across all 50 states, Utah’s legislation goes further by giving PTs official designation as primary care providers”within their defined scope of practice. Specifically, this applies to the evaluation, diagnosis, and management of neuromusculoskeletal disorders.

This policy change removes barriers to care, allowing physical therapists to function more autonomously, triage patients effectively, and deliver timely interventions without administrative delays. For patients, this translates into faster recovery, reduced costs, and streamlined care. It also carries significant implications for physical therapy reimbursement under various insurance plans.

A Win for Patients and Providers

One of the most immediate impacts of this change is improved access to care. Musculoskeletal disorders such as low back pain, neck pain, and joint dysfunctions are among the most common reasons individuals seek medical attention. Empowering PTs to act as the initial point of contact for these conditions helps alleviate pressure on primary care physicians and emergency departments.

Patients will benefit from:

• • Utilize their full training and licensure
  • Manage patients more efficiently
  • Increase their value within interdisciplinary care teams

Why Utah?

Utah has long been a state that prioritizes innovation in healthcare. With a robust population of physical therapists and a legislative environment open to scope of practice reform, Utah was well-positioned to become the first state to enact such a policy.

APTA Utah played a pivotal role in securing this legislative win. The organization engaged in sustained lobbying efforts, met with lawmakers, and provided educational materials demonstrating the clinical and economic value of direct PT access. This collaboration between the profession and policymakers exemplifies what’s possible when advocacy is rooted in evidence and public need.

The Scope of Primary Care for PTs

It is important to note that this primary care designation does not mean PTs are now responsible for general medical care. Instead, they are recognized as primary care providers specifically for patients with neuromusculoskeletal issues.

This includes:

• • Conducting comprehensive evaluations
  • Ordering and interpreting appropriate diagnostic imaging (where allowed)
  • Developing and implementing treatment plans
  • Referring patients to other providers when conditions fall outside their scope

This model mirrors how primary care physicians manage care, with the key distinction that PTs focus specifically on the neuromusculoskeletal system.

Safeguards and Collaboration

As with any scope expansion, ensuring patient safety remains paramount. The legislation includes safeguards requiring PTs to refer patients to appropriate medical providers when symptoms indicate a non-musculoskeletal cause or if red flags arise during examination.

Furthermore, the policy encourages collaborative care. Physical therapists will continue to work closely with physicians, nurse practitioners, and specialists to ensure patients receive comprehensive care.

Comparisons with Other States

While Utah is the first state to take this step, the trend is likely to spread. Many states already allow direct access to PT services for a certain number of visits or days without a referral. However, these laws often come with limitations, such as requiring prior physician evaluation for complex cases or restricting billing rights.

Utah’s legislation goes a step further by explicitly defining PTs as primary care providers within a specific clinical domain. This provides clarity for insurers, licensing boards, and patients, and it may serve as a blueprint for similar laws in other jurisdictions.

Reimbursement and Billing Implications

A crucial question for many therapy professionals is: How does Utah PT primary care affect reimbursement? One of the most significant implications of designating PTs as primary care providers is the potential impact on physical therapy reimbursement structures.

Insurers will now need to adapt their policies to recognize PTs as primary care providers for eligible conditions. Navigating changes in physical therapy reimbursement will be vital for clinics.

This change may influence:

• • Reimbursement rates and coverage policies
  • Direct billing for evaluations and plan of care without physician signature
  • Inclusion of PTs in value-based care models

The onus will be on both providers and payers to navigate this transition in a way that maintains compliance while ensuring patient care remains uninterrupted and fair physical therapy reimbursement is achieved.

Implications for Education and Training

As PTs take on more autonomous roles, academic programs and continuing education providers will need to evolve accordingly. Training must increasingly focus on differential diagnosis, clinical reasoning, and primary care principles.

This shift may include:

• • Expanded coursework in medical screening and pharmacology
  • Increased clinical residencies focused on first-contact care
  • Training on interprofessional communication and care coordination

By investing in these areas, the profession can ensure that PTs are fully prepared for their expanding roles as primary care providers in their specific domain.

A Role for Technology and EMR Integration

Managing increased autonomy also means managing more clinical data and ensuring compliance with state and federal guidelines, including those related to physical therapy reimbursement. Here is where advanced EMR platforms like HelloNote play a critical role.

HelloNote provides physical therapy clinics with a comprehensive platform that supports the entire care continuum, from initial intake through discharge. As PTs in Utah and potentially other states step into primary care roles, HelloNote can facilitate:

• • Seamless documentation of evaluations and functional assessments
  • Integration of diagnostic tools and outcome measures
  • Compliance with Medicare and payer-specific billing requirements
  • Secure communication with referring providers and care teams

This level of integration not only supports regulatory compliance but also enhances patient outcomes by ensuring continuity and accuracy in care.

What Comes Next

Utah’s legislation is a watershed moment for physical therapy, but the journey is far from over. Implementation will require coordination between regulatory bodies, payers, providers, and educational institutions. Ongoing research and data collection will be necessary to measure the impact of this policy on access, costs, outcomes, and physical therapy reimbursement models.

Physical therapists across the country should view this development as an invitation to engage more deeply in advocacy (following the example set by APTA Utah), professional development, and interprofessional collaboration

Conclusion

Utah’s recognition of physical therapists as primary care providers for neuromusculoskeletal conditions sets a new standard for the profession. This bold step affirms the critical role of PTs in managing musculoskeletal health, increases access to care, and lays the groundwork for similar reforms nationwide. Successfully navigating the changes, particularly around physical therapy reimbursement, will be key.

With the right tools, training, and collaboration, physical therapists are well-positioned to meet the evolving needs of the healthcare system, and platforms like HelloNote will be essential partners in supporting this expanded scope of care.

Stay updated on the Medicare telehealth extension for 2025 and its impact on therapy practices. Learn about policy updates, supervision changes, and how therapists can continue providing remote care under the Appropriations and Extensions Act, 2025.

The Senate recently passed the Continuing Appropriations and Extensions Act, 2025, which proposes to extend telehealth services for physical therapists, occupational therapists, and speech-language pathologists through September 30, 2025. However, this bill has not yet been enacted into law and still requires approval from the Senate and the President’s signature before taking effect. Until then, the current officially enacted extension remains through March 31, 2025, as previously established under the American Relief Act, 2025. 

This extension, if approved, would ensure that therapy providers can continue offering remote services to Medicare beneficiaries, allowing for greater access to care, particularly in rural and underserved areas. 

However, this legislation does not include changes to the Medicare Physician Fee Schedule conversion factor, meaning that reimbursement rates remain flat despite rising costs. Therapy professionals must carefully navigate these financial challenges while leveraging new opportunities created by the policy updates. 

Key Policy Updates Impacting Therapy Practices in 2025

Extension of Telehealth Services 

One of the most significant provisions in the Continuing Appropriations and Extensions Act, 2025, is the temporary extension of telehealth services for therapy providers. Physical therapists, occupational therapists, and speech-language pathologists will be able to continue delivering virtual care to Medicare beneficiaries until September 31, 2025. This is particularly beneficial for reaching patients in rural or underserved areas and for those with mobility challenges. 

General Supervision for Therapy Assistants 

A major regulatory change in the 2025 final rule allows physical therapists in private practice and occupational therapists in private practice to use general supervision for physical therapist assistants and occupational therapy assistants for all applicable outpatient therapy services. This provides greater flexibility in managing therapy assistants, streamlining practice operations, and enhancing patient care coordination. 

Certification of Therapy Plans of Care 

CMS has introduced an important exception to the physician/nonphysician practitioner signature requirement for initial therapy plan certifications. If a signed order or referral from a physician/NPP is on file, and the treatment plan is transmitted to the physician/NPP within 30 days of the initial evaluation, the initial certification will be considered valid. This change simplifies administrative requirements for therapy clinics while maintaining physician oversight. However, this exception does not apply to recertifications. 

Expansion of Telehealth Services for Caregiver Training 

CMS has expanded telehealth coverage to include caregiver training services, recognizing the essential role caregivers play in patient care. New Medicare-approved codes allow therapists to provide training in direct care and behavior management through telehealth. The key additions to the Medicare Telehealth List include: 

• • G0541-G0543: Direct care training services, such as wound care, infection control, diet preparation, and medication administration. 

• • G0539-G0540: Behavior management and modification training for caregivers. 

This expansion allows therapy providers to educate caregivers remotely, improving patient outcomes while increasing revenue opportunities for clinics offering these services. 

For a more in-depth look at how to navigate caregiver training codes and maximize billing success, visit HelloNote’s guide on updated caregiver training codes for 2025. 

Lack of Adjustments to the Medicare Physician Fee Schedule  

Despite these advancements, therapy providers will not see an increase in Medicare reimbursement rates in 2025. The MPFS conversion factor will decrease by approximately 2.83 percent, reflecting continued downward pressure on provider payments. This presents financial challenges for therapy clinics already managing increased operational costs. Practices must focus on efficiency, optimized billing processes, and strategic use of telehealth to maintain profitability. 

How HelloNote Supports Therapy Practices in 2025

With Medicare reimbursement rates remaining stagnant and operational costs increasing, therapy practices need a system that streamlines workflows and ensures financial stability. HelloNote offers a comprehensive electronic medical record (EMR) solution designed to optimize billing, documentation, and telehealth services while keeping practices compliant with evolving regulations. 

Optimized Billing and Faster Reimbursements 

HelloNote helps therapists manage claims efficiently with: 

• • Automated claims submission to minimize denials and delays. 

• • Integrated insurance verification tools to prevent errors and ensure proper billing. 

• • Faster reimbursement processing, improving cash flow for therapy clinics. 

Seamless Telehealth Capabilities 

With telehealth extended through September 2025, therapy providers must ensure they have the right tools for virtual care. HelloNote’s built-in telehealth features enable therapists to: 

• • Conduct HIPAA-compliant virtual sessions. 

• • Seamlessly document telehealth visits for Medicare compliance. 

• • Expand patient access to therapy services beyond geographic limitations. 

Support for Therapy Assistants 

With the shift to general supervision for PTAs and OTAs, therapy clinics can structure their services more efficiently. HelloNote provides intuitive scheduling and workflow management tools to support this transition while maintaining compliance with supervision requirements. 

Simplified Certification and Documentation 

With the new exception for initial therapy plan certifications, practices must ensure they have an efficient documentation system. HelloNote provides: 

• • Secure storage and transmission of treatment plans to meet Medicare requirements. 

• • Tracking tools to document physician orders and referrals. 

• • Pre-built compliance templates that streamline administrative tasks. 

Preparing for the Future of Therapy Practice Management

The Continuing Appropriations and Extensions Act, 2025, brings both opportunities and challenges for therapy providers. The telehealth extension and expanded caregiver training services allow therapists to reach more patients and provide additional services. However, the lack of reimbursement increases means practices must focus on efficiency and cost management to stay financially sustainable. 

HelloNote is designed to help therapy practices navigate these changes effectively. By integrating smart billing, telehealth tools, and compliance-friendly documentation, therapy providers can focus on delivering quality care while optimizing financial performance. 

Therapists looking to adapt to the latest Medicare updates can explore how HelloNote supports compliance, efficiency, and financial success. 

Discover how ProKinetics Physical Therapy transforms the lives of war veterans through advanced prosthetic rehabilitation. From personalized therapy to emotional healing, learn how cutting-edge technology and compassionate care help amputees regain mobility, independence, and hope. Plus, see how HelloNote EMR enhances seamless patient recovery.

At ProKinetics Physical Therapy, healing goes beyond just rehabilitation. It’s about restoring hope, independence, and quality of life. In a remarkable effort to support those who have given everything in the fight for their homeland, ProKinetics provides cutting-edge prosthetic rehabilitation and therapy services to Ukrainian war veterans who have suffered limb amputations. 

From the Battlefield to Recovery

As the war in Ukraine continues, countless soldiers have endured life-altering injuries, many requiring specialized medical attention. Staten Island has become a haven for some of these wounded warriors, offering them a chance to rebuild their lives. 

Two such veterans, Vitaliy Fomenko and Hennadiy Degtyar, traveled to the U.S. seeking advanced prosthetic fittings and rehabilitation. ProKinetics Physical Therapy has been at the forefront of their prosthetic rehabilitation journey, providing them with the care needed to adapt to life with prosthetics. 

Their journey has gained attention, with The New York Post highlighting their struggles and recovery in a recent article: Ukraine war vets with amputations flee to NYC for refuge and care: ‘It’s a war of exhaustion’. This article sheds light on the challenges these veterans face and the critical role rehabilitation centers like ProKinetics play in their recovery process. 

The Emotional and Physical Journey of War Veterans

The transition from the battlefield to civilian life is both physical and psychological. Losing a limb is not just about adapting to prosthetics; it’s about redefining identity, regaining confidence, and finding strength to move forward. 

At ProKinetics, the team understands that healing extends beyond physical therapy. These veterans, who once stood strong in defense of their homeland, now face an entirely new battle, learning to walk, function, and live with prosthetic limbs. The emotional toll is immense, but through personalized therapy, emotional support, and structured rehabilitation programs, they are finding renewed strength.

Comprehensive Support for Veterans: 

• • Mental Health Support – Therapy is more than movement. It’s about rebuilding confidence and overcoming trauma. ProKinetics collaborates with mental health professionals to ensure patients receive holistic care. 

• • Mind-Body Therapy – Integrating breathing exercises, relaxation techniques, and mindfulness practices to help manage pain and anxiety. 

• • Reintegration Programs – Veterans engage in adaptive sports and community activities, helping them transition into a life filled with purpose. 

One of the most remarkable moments in this journey is watching a veteran take their first steps again, a moment filled with emotion, determination, and gratitude. The staff at ProKinetics witness firsthand the power of resilience as these warriors push through unimaginable challenges to regain independence. 

The Role of ProKinetics in Advanced Prosthetic Rehabilitation

Recovery is highly individualized, requiring specialized care, cutting-edge technology, and unwavering support. At ProKinetics Physical Therapy, each patient undergoes a personalized prosthetic rehabilitation program tailored to their needs: 

• • Targeted Therapy Programs – Designed to support amputee rehabilitation and prosthetic mobility training. 

• • Strength and Balance Training – Helping patients develop stability, coordination, and confidence in their movements. 

• • One-on-One Therapy Sessions – Ensuring each patient receives focused attention and guidance on their unique rehabilitation path. 

Veterans arrive at ProKinetics uncertain about their future, but through dedicated care and advanced prosthetic rehabilitation techniques, they leave with a renewed sense of hope and purpose. 

A Seamless Approach to Patient Care

At ProKinetics Physical Therapy, the focus is always on delivering exceptional, patient-centered rehabilitation. Achieving the best outcomes requires not only skilled therapists and advanced prosthetic technology but also efficient documentation and coordination behind the scenes. 

This is where HelloNote EMR supports ProKinetics by ensuring seamless workflows that enhance both patient care and operational efficiency. 

How HelloNote EMR Enhances Prosthetic Rehabilitation: 

• • Real-Time Documentation & Progress Tracking – Helping therapists track patient improvements effortlessly, ensuring treatment plans evolve with their recovery needs.
  • Telehealth & Virtual Check-Ins – Allowing for continued care beyond in-person sessions, keeping patients engaged in their rehabilitation journey.
  • Data-Driven Outcome Monitoring – Providing insightful progress reports, helping therapists and patients stay aligned on recovery milestones. 

By integrating HelloNote EMR’s technology, ProKinetics can focus on helping patients regain independence while ensuring that behind-the-scenes processes run smoothly. With the right tools in place, therapists can devote more time to guiding patients toward a stronger, healthier future. 

Join Us in Supporting This Mission

The stories of Vitaliy, Hennadiy, and many other veterans serve as powerful reminders of the human impact of war and the importance of compassionate, high-quality prosthetic rehabilitation. 

Are you or a loved one in need of prosthetic rehabilitation? Schedule a Consultation with ProKinetics Today! 

Visit ProKinetics Physical Therapy to see how we are making a difference.

Discover how HelloNote is transforming therapy practices with advanced technology—Book a Free Demo Today! 

Together, we can help those who have sacrificed so much regain strength, mobility, and independence. 

This article explores UnitedHealthcare’s updated prior authorization policy for Medicare Advantage members, which simplifies access to therapy services like physical therapy, occupational therapy, and speech-language pathology. Starting January 13, 2025, the policy allows automatic coverage for up to six initial visits within eight weeks without a clinical review under specific conditions, reducing delays and improving patient outcomes. Learn how these changes streamline administrative tasks for providers while enhancing care continuity and efficiency.

UnitedHealthcare® has recently updated its prior authorization requirements for therapy and chiropractic services, effective from January 13, 2025. This change is particularly relevant for physical therapists, occupational therapists, and speech-language pathologists, as it simplifies the process and ensures timely care for Medicare Advantage Individual and Group Retiree members. 

Key Changes in Prior Authorization

Under the new policy, providers must still submit a prior authorization request for the entire plan of care, including the full duration and number of visits requested. However, a significant update allows up to the first six visits of a member’s initial plan of care to be covered without a clinical review, provided these visits occur within eight weeks of the first date of service. This adjustment facilitates immediate treatment following the initial consultation, which is crucial for effective therapy outcomes. 

Conditions for Automatic Coverage

The automatic coverage of the initial consultation and up to six visits within eight weeks applies under the following circumstances: 

• • The member is new to your clinic. 

• • The member presents with a new condition. 

• • The member has had a gap in care of 90 or more days. 

These conditions ensure that members can receive prompt care without unnecessary delays, which is essential for conditions requiring immediate intervention, such as gait deviations, shoulder mobility issues, or speech and language impairments. 

Streamlined Process for Therapists

For therapists, this policy change means that the initial six visits can commence immediately, allowing for a more efficient start to the treatment plan. Providers can request authorization up to 10 business days after the initial consultation, ensuring that the member’s care is not interrupted. This is particularly beneficial for addressing acute conditions that require swift intervention, such as post-stroke rehabilitation, post-surgical recovery, or acute musculoskeletal injuries. 

Ensuring Continuity of Care

Once the initial plan of care is complete, additional visits may be requested through the standard authorization process via the Optum Provider Portal. This ensures that ongoing care is appropriately managed and that members continue to receive the necessary therapy services. Providers are encouraged to submit claims for care following the receipt of approved authorization to ensure seamless coverage. 

Impact on Therapy Practices

This policy update is expected to have a positive impact on therapy practices by reducing administrative burdens and allowing therapists to focus more on patient care. By covering the initial visits without a clinical review, therapists can quickly address critical issues such as improving a patient’s ability to perform daily activities, enhancing mobility, and facilitating better communication skills. 

Conclusion

The updated prior authorization requirements by UnitedHealthcare® represent a significant step towards improving access to therapy services for Medicare Advantage members. By allowing immediate coverage for the initial visits, therapists can provide timely and effective care, ultimately leading to better patient outcomes. Clinic owners and therapists should familiarize themselves with these changes to ensure they can take full advantage of the streamlined process and continue to deliver high-quality care to their patients. 

 

How UnitedHealthcare’s prior authorization policies impact therapy practices and patient care. Discover challenges faced by providers and how it affects patient access to services.

On September 1st, 2024, UnitedHealthcare (UHC) introduced new prior authorization requirements for outpatient physical, occupational, and speech therapy services under its Medicare Advantage plans nationally. These changes took many providers by surprise, with therapists and patient advocates reporting widespread confusion and frustration due to UHC’s poor communication and problematic rollout. In case you missed that update; you can read the article we wrote about it “Adapting to UnitedHealthcare Clinical Submission Requirements 2024”. 

In the weeks following the implementation, numerous issues have surfaced, with therapists facing extensive delays in authorizations, reduced treatment sessions, and a growing administrative burden. For patients, this means a disruption in care—particularly concerning for those relying on timely, consistent therapy to manage chronic conditions or recover from injuries. 

Impact on Patient Care

One of the most immediate and concerning outcomes of UHC’s new prior authorization requirements is the direct impact on patient care. Therapies like physical, occupational, and speech therapy depend on regular, uninterrupted sessions to deliver meaningful progress. When authorizations are delayed or reduced, patients experience setbacks that can be difficult to overcome. 

Many therapists are already reporting significant delays in receiving approvals for treatment sessions. This disruption in care continuity can hinder recovery for patients who require ongoing therapy, particularly those with chronic conditions or post-surgery rehabilitation needs. The emotional toll is also evident, with some patients expressing frustration and even breaking down in tears over the uncertainty of when—or if—they’ll receive the care they need. 

Adding to the issue, many authorization approvals grant fewer sessions than therapists initially request. This not only undermines a therapist’s clinical judgment but also places unnecessary limits on patients’ ability to achieve their full recovery potential. Each patient is unique, and cookie-cutter authorization policies fail to address the individualized nature of therapeutic care. 

Financial Strain on Practices

For many therapy practices, particularly smaller or independent clinics, UnitedHealthcare’s new prior authorization system is creating a significant financial burden. The delays in receiving authorizations leave therapists in a difficult position: continue treating patients without certainty of reimbursement or deny patients the care they need. Neither option is sustainable. 

Therapists face the very real risk of providing services without payment if prior authorizations aren’t approved in time. With this policy affecting practices nationwide, smaller practices—already operating on tight margins—are in an even more precarious financial position. Many simply cannot afford to offer care without the guarantee of payment, and the fear of losing income has become a serious concern for therapists across the country. 

Furthermore, the increased administrative workload has added to the financial strain. Practices are now dedicating more time and resources to navigating UHC’s problematic system—waiting on hold for hours, resubmitting requests, and managing faulty portals—all while patient care takes a back seat. The additional administrative time is both costly and frustrating, diverting energy away from the core mission of helping patients. 

Erosion of Patient Trust and Emotional Toll

The impact of UnitedHealthcare’s prior authorization delays extends far beyond logistical and financial issues. For many patients, especially those in the Medicare population, these delays are more than just frustrating—they’re emotionally devastating. Therapists have witnessed patients break down in tears due to postponed or denied care, leaving them feeling helpless in a system that seems indifferent to their needs. 

This erosion of trust not only affects patients’ confidence in the healthcare system but also strains the therapist-patient relationship. Despite therapists’ best efforts to advocate for timely care, the limitations imposed by UHC’s process can make it appear as though the therapist is at fault when treatment is delayed or denied. Patients may not fully understand the complex insurance barriers at play, and when they don’t receive the care they were expecting, their dissatisfaction can sometimes be unfairly directed at the therapist. 

Additionally, the emotional toll on therapists themselves is significant. Knowing that a patient isn’t receiving the necessary care despite your recommendations can be demoralizing. As healthcare providers dedicated to improving lives, therapists feel a deep sense of responsibility toward their patients’ well-being, and UHC’s administrative barriers are making it harder to fulfill that commitment. 

Lack of Communication and Support from UHC

Another critical issue is UnitedHealthcare’s failure to communicate effectively with therapists and practices. The abrupt rollout of the new prior authorization requirements came with little warning, leaving many providers scrambling to adjust. Notices were often delayed, unclear, or entirely missing, causing widespread confusion about the new policies. For many, the first indication of these changes came only when patients were already being denied services. 

This lack of transparency extends to the ongoing issues with UHC’s systems. Therapists have reported system outages, excessively long wait times, and overall difficulty in navigating UHC’s portal to submit authorizations. Instead of providing the support needed to transition smoothly, UHC’s communication channels have been largely unresponsive, exacerbating the frustrations of therapists who are trying to advocate for their patients. 

The exclusion of physical therapists from UHC’s “gold card” program is another sore point. This program allows certain physician specialties to bypass the prior authorization process altogether, yet therapists—despite their essential role in patient recovery—have been left out. This exclusion adds to the growing sense among physical therapists that they are being undervalued, and that their voices are not being heard within the broader healthcare system. 

Harm to the Healthcare System

UnitedHealthcare’s new prior authorization requirements are not only damaging to therapists and patients—they are also counterproductive to the healthcare system as a whole. Physical, occupational, and speech therapies are among the most cost-effective treatments available. By delaying or limiting these services, UHC risks increasing healthcare costs in the long run. For patients who are unable to receive timely care, minor conditions may worsen, leading to more invasive and expensive interventions such as surgeries or long-term medication. 

Moreover, the restrictions placed on therapy sessions could exacerbate healthcare inequality. Smaller practices, particularly those in underserved or lower-income communities, are hit hardest by the financial strain caused by these delays. When practices are forced to turn away patients or risk not being paid, access to essential therapy services becomes even more limited for vulnerable populations. This not only harms patient outcomes but also disrupts the role that therapy plays in preventing larger health issues down the line. 

By creating additional barriers to affordable care, UHC’s policies contradict their supposed aim of reducing healthcare costs. The immediate financial burden may shift to patients and practices, but the long-term strain will inevitably fall on the healthcare system as a whole. 

UnitedHealthcare’s new prior authorization requirements are a stark reminder of the disconnect between policy and patient-centered care. While intended to control costs and ensure appropriate treatments, these requirements are instead creating a heavy burden on therapists, patients, and the healthcare system. From delays in patient care and reduced therapy sessions to financial strain on practices, especially smaller ones, the fallout is widespread and damaging. 

For therapists, the most concerning aspect is how these policies undermine the very essence of our work—ensuring timely, effective care for our patients. It’s disheartening to see clinical judgment overridden by arbitrary limits, leaving patients with insufficient care. The lack of communication from UHC and the exclusion of therapists from solutions like the “gold card” program only adds to the frustration. 

Ultimately, this policy risks setting back progress in patient outcomes, increasing healthcare costs, and deepening healthcare inequality. The therapy community is committed to advocating for patient well-being, but without adequate support and communication from insurers like UHC, it becomes an uphill battle. Change is urgently needed to ensure that prior authorization requirements don’t continue to harm both patients and the healthcare system. 

Is your practice struggling with the impact of UnitedHealthcare’s prior authorization policies? Learn how HelloNote’s seamless integration can streamline your billing process and reduce administrative burdens. Stay focused on patient care—schedule a demo with HelloNote today!

Here is the updated article as of January13, 2025 about the New UnitedHealthcare® Policy Streamlines Therapy Services for Medicare Advantage Members.