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Co-pay Reform

Co-pay Limit for Physical Therapy Signed into Law!

APTA Vermont has been pursuing co-pay limitations for PT services for the past few years and we have succeeded! On June 25th the Governor signed bill S.1 into law.  While it does represent a compromise of interests, this is a huge success, particularly as we got it passed during a busy special session.

Here are some details:

  • Co-pays for PT services are limited to 125%-150% of primary care co-pay amounts for silver and bronze insurance plans. Platinum and gold plan co-pays  are not subject to this limitation (current co-pays are $30 for these plans)
  • Example co-pay ranges (based on 2018 plans):
    • ~$38 – $60 compared with $50 – $100 depending on plan
  • These changes go into effect for new plans after January 1, 2020 and no later than January 1, 2021

The law also convenes a working group to study insurance coverage of non-pharmacological treatment for pain. APTA Vermont is working on having input into that group so that we can continue to lead the way to increasing access to physical therapy services.

Click HERE for discussion points on the need for improved access and the impact PT can have on Vermonters’ lives.

Click HERE for a copy of the bill as passed and signed.

APTA Vermont needs your help to continue the work of improving access to physical therapy throughout Vermont.

Click HERE to lend a hand

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