state_legiscan_drain · NY
Provides that any copayment or coinsurance amount charged by an insurer to the insured for services rendered by a physical therapist or an occupational therapist shall not be more than twenty-five percent greater than the copayment or coinsurance amount imposed for an office visit to a licensed primary care physician or osteopath for the same or a similar diagnosed condition.
February 18, 2025
Summary
If enacted, this bill would cap copayments or coinsurance for physical and occupational therapy at no more than 25% above the amount charged for a primary care physician office visit for the same condition. Insurers would be required to adjust their cost-sharing structures, potentially reducing out-of-pocket costs for therapy services. Consumers would benefit from more predictable and equitable cost-sharing for therapy compared to primary care visits.
AI-generated summary · Jun 8, 2026. Verify with your compliance counsel before acting.
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Source: https://www.nysenate.gov/legislation/bills/2025/S5045
Common questions
- What does "Provides that any copayment or coinsurance amount charged by an insurer to the insured for services rendered by a physical therapist or an occupational therapist shall not be more than twenty-five percent greater than the copayment or coinsurance amount imposed for an office visit to a licensed primary care physician or osteopath for the same or a similar diagnosed condition." cover?
- If enacted, this bill would cap copayments or coinsurance for physical and occupational therapy at no more than 25% above the amount charged for a primary…
- When was it published?
- It was published on February 18, 2025.