Oct. 3, 2019
Texas House Bill (HB) 29, changed the Texas Occupation Code that required a physician to diagnose the need for physical therapy before a physical therapist can treat a patient for services rendered as of Nov. 1, 2019.
HB29 expands a physical therapist’s scope of licensure to remove this requirement, allowing patients to access a physical therapist without a prescription for a limited number of visits.
However, the bill did not modify the Texas Insurance Code. Therefore, if the Blue Cross and Blue Shield of Texas (BCBSTX) member’s health plan requires a referral or prior approval and use of in-network physical therapists, those requirements still apply.
It is imperative that physical therapists obtain eligibility and benefits to confirm membership, verify coverage, determine if they are in-network for the member's policy and determine whether prior authorization is required through Availity® or their preferred vendor before treating any member without a referral. Availity allows prior authorization determination by procedure code. Refer to the BCBSTX Eligibility and Benefits page for more information on Availity.
If you have any questions, contact your Provider Network Representative.