Healthfirst Announces Update to Standard Fee Schedule for Therapy Services

Earlier this year, Healthfirst unveiled a significant update to its Standard Fee Schedule for specific therapy services, including acupuncturist, occupational therapy, physical therapy, and speech therapy codes. In a strategic move aimed at enhancing payment efficiency and provider experience, Healthfirst is transitioning from a “fee-for-service” reimbursement model to a “per diem” rate structure for these services. 

Transition to Per Diem Rate: 

Under the new per diem rate structure, Healthfirst will no longer reimburse providers on a per Current Procedural Terminology (CPT) code basis. Instead, providers offering acupuncturists, occupational therapy, physical therapy, and speech therapy services will receive reimbursement based on a daily rate, irrespective of the specific CPT codes billed. 

Effective Date Delayed: 

Originally scheduled to take effect on April 1, 2024, Healthfirst has decided to delay the implementation of these changes to June 1, 2024. This extension allows providers additional time to familiarize themselves with the new reimbursement structure and make any necessary adjustments to their billing practices. 

Clarification and Assistance: 

Providers with questions or concerns regarding the updates to the Healthfirst Standard Fee Schedule(s) are encouraged to reach out via email to DSEProviderRaterequests@healthfirst.org. When contacting Healthfirst, providers should ensure to include their Tax Identification Number (TIN) and specialty in the email request. It ensures that Healthfirst can provide accurate and tailored assistance to address any inquiries promptly. 

Source: https://hfproviders.org/whatsnew/new-effective-date-for-acupuncture-occupational-therapy-physical-therapy-and-speech-therapy-standard-fee-schedule-rates