New York Proposes To Lift The Cap On Therapy Services Provided To Medicaid Recipients

September 8, 2020


On September 2, 2020, the New York State Department of Health submitted a proposal to the Centers for Medicare & Medicaid Services (“CMS”) to remove the annual Medicaid caps for physical therapy, occupational therapy, and speech therapy visits available to Medicaid recipients. The change, planned to take effect on October 1, 2020, would remove the current limitation on the number of therapy visits a Medicaid recipient may have and, in its place, allow medical necessity to dictate the number of visits a recipient can receive in a year.

This change, which must be approved by CMS before it can take effect, would allow therapists to provide services based on a patient’s need, which potentially expands the number of visits allowed, and would apply to recipients covered under both Medicaid fee for service and Medicaid managed care.

* * * * *

Should you have any questions regarding this Alert, please contact the Garfunkel Wild attorney with whom you regularly work, or contact us at

Click Here to download the Legal Alert.