Question PA Medicaid & PT Direct Access Policy


Elizabeth, PA
Best answers
We are having a company discussion about the rules for physical therapy direct access with PA Medicaid, especially for plans like UPMC for You that do not require an authorization. We know the direct access rules from the PA State Practice Act. However, the discussion is centered around whether an individual with a plan like UPMC for You, a Medicaid Product, can be seen Direct Access (without a script or referral from a physician). I am specifically looking for a reference, provider manual, or something that can be shared to make sure everyone is on the same page that addresses Direct Access for Medicaid patients. Currently, we have several perspectives, and what people "know" from their own knowledge or experiences but no one can put their hands on anything in black and white. Anything is appreciated. Thank you in Advance!