New York Physical Therapy Association Pushes for Fair Co-Pays


The New York Physical Therapy Association

Stop high co-payments. Meet Assemblyman Tedisco

Friday, December 4, 2015 at 11:00 AM

The Scotia Office of Physical Therapy Associates of Schenectady
42 Saratoga Road, Scotia, NY 12302

The New York Physical Therapy Association (NYPTA) is working to end the unfair practice of outrageous “specialty” co-pays, which can cost patients thousands of additional dollars and result in foregone treatment.

NYPTA is asking members of the State Legislature to support A.1063A sponsored by Assemblyman Cahill and the Senate same as bill, S.28A sponsored by Senator DeFrancisco. The bills provide that no health care policy shall impose co-payments in excess of twenty percent of total reimbursement to the provider of care.

Currently, co-pay fees are not limited and equal the amount reimbursed to the physical therapist. For example, some co-pays are as much as $50 per visit for physical therapy treatments that require up to 12 or more sessions per month. The additional co-pays for this patient would be $600 per month. Meanwhile the PT reimbursement might only be $50 per visit, meaning the patient is paying 100% of the per visit costs. The insurer has placed the entire burden of cost on the patient.

“The imposition by managed care companies of ever increasing physical therapy copays is one of the most pressing issues facing the profession at this time.” Said Michael Mattia, PT, DPT, MS, MHA, President, NYPTA, “Health plans continue to progressively defund physical therapy as a covered benefit and shift the cost onto consumers by imposing high specialty copayments for physical therapy visits. The end result is that our patients are shouldering the overwhelming cost of their physical therapy care as they or their employer continues to experience significant increases in health insurance premiums.”

The end result is the consumer is paying more for their coverage and being burdened with higher out of pocket costs when requiring a mandated health care service, which may, and in fact in many cases does result in patients opting not to participate in vital restorative physical therapy care.

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About NYPTA: The New York Physical Therapy Association is a professional, non-profit association of approximately 6500 Physical Therapists (PTs), Physical Therapist Assistants (PTAs) and PT/PTA students. The NYPTA is dedicated to serving the public’s health interests, improving the standard of health for people of all ages and advancing the benefits of physical therapy and the interests of physical therapy professionals in state of New York. To learn more about the New York Physical Therapy Association please visit

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