Release 3
2024 Program Updates — New limit on physical therapy sessions
For any Need started on or after November 1, 2024, we are reducing the number of therapy sessions allowed per Need from 40 to 20.
Our data shows that among Needs that have included physical therapy, 75% have not submitted more than 20 sessions. We therefore see this as an opportunity to save costs for the entire membership but affect as few members as possible.
Frequently Asked Questions
Members have told us that if program changes would be needed, they would prefer lower Shares and minimized Share increases more than anything else. To keep Share increases as low as possible, we looked at many aspects of the ministry to determine where we could make adjustments that would reduce the dollar amount of bills shared and impact the fewest number of members.
Several years ago, the maximum number of therapy sessions per Need had been 20. We had increased it to 40. In subsequent years, our data has shown that in 75% of Needs in which therapy bills were submitted, members used 20 or fewer therapy visits. Considering the high rate of medical inflation costs, we felt going back to the limit of 20 sessions per Need was a good opportunity for significant savings while impacting the fewest number of members.
No. For your existing Need, we will keep the maximum number of sessions at 40—we will honor the Guidelines for therapy that were in place when you started your existing Need. For any Needs started on or after November 1, 2024, the maximum number of therapy sessions will be 20.