On July 26, 2006, Gov. Pataki signed S. 3169 into New York State law. New York State now allows consumers the ability to directly access the services of a physical therapist with minor limitations. The law took effect November 25, 2006.

The new law allows consumers to directly access the services of a physical therapist for 10 visits or a period of 30 days, whichever occurs first. Additionally, the physical therapist needs to have three years of practice experience to provide direct access services. Lastly legislation stipulates that the physical therapist needs to inform the consumer in writing insurance may not cover the service.

The law does not change the requirement under the insurance law that health insurers need to only cover physical therapy rendered pursuant to a referral. Also, this law amends insurance law to make it explicit data referral is required for purposes of no-fault. No-fault amendment means that patients with a claim under the no-fault program would not be eligible for reimbursement for physical therapy services without a referral. This requirement is in keeping with no-fault current practice.

While we believe direct access to be a significant benefit for many patients, the rules, regulations and reimbursement for specific situations or patients insurers may be confusing and/or complicated. Have questions? Contact us and we will help you understand how this benefit pertains to specific needs and insurance coverage.