As we begin the new year, some of your patients who began therapy prior to January 1, 2025 will have a different insurance for dates of service on and after January 1, 2025. That leads to a frequent question I receive. When a patient switches insurance during an episode of outpatient therapy, is a new evaluation required? In this article, I will answer the following questions:

UnitedHeathcare (UHC) Medicare Advantage has updated the prior authorization process for outpatient physical, occupational, and speech therapy services. In this article, I will answer the following questions:

UnitedHealthcare (UHC) Medicare Advantage (MA) has revised their therapy policy that has implications for skilled nursing facilities, long-term acute care hospitals, and outpatient therapy providers which includes private practices, hospitals, and comprehensive outpatient rehabilitation facilities. The effective date of this revision is August 1, 2024. If you treat UHC MA patients, you need to read this policy. To access the revised policy, click

The Centers for Medicare and Medicaid Services (CMS) implemented what has become known as the “8-minute rule” on April 1, 2000. We all know this rule applies to traditional Medicare and outpatient therapy, but what about Medicare Advantage, federal insurance carriers, Medicaid, and commercial insurance carriers? In this article, I will answer the following questions:

A question I am often asked is do all Medicare Advantage (MA) plans follow traditional Medicare’s “8-minute rule”. The answer depends on the MA plan. Regarding Aetna MA and do they follow Medicare’s “8-minute rule”, the answer is

In this article, I will answer the following questions:

In this article, I will answer the following questions regarding the Merit-Based Incentive Payment System (MIPS) and the applicable payment adjustments and how they apply to Medicare Advantage plans:

QuestionMust Medicare Advantage plans cover maintenance therapy in the same manner that traditional Medicare covers maintenance therapy? Answer