Relates to copayment and coinsurance charged for physical and occupational therapy services

2025 Regular Session Introduced by Scott Bendett and 9 co-sponsors

A 6484 would change copayments and coinsurance for physical and occupational therapy, affecting patient out-of-pocket costs and how plans and providers bill for PT/OT.

REFERRED TO INSURANCE

Overview

Assembly Bill A 6484, introduced March 5, 2025, would relate to the copayment and coinsurance charged for physical therapy (PT) and occupational therapy (OT) services. The bill’s exact statutory changes are not provided here, but the title indicates a focus on how patients are financially accountable for PT and OT under insurance coverage.

Key status and actions:
- Status: Ordered to third reading (Rules CAL.569)
- Legislative actions include multiple referrals, amendments, and reports in May–June 2025, with the bill repeatedly reported and ultimately ordered to a third reading.
- Print number: 6484A (May 5, 2025)
- Referred to Insurance upon introduction; amendments and re-refer to Insurance occurred, followed by progression through Rules and Third Reading stages.

Key provisions (as indicated by the bill’s title)

The bill would modify regulations governing copayments and coinsurance for physical and occupational therapy services.

Likely aims to influence the amount or structure of patient cost-sharing for PT/OT, potentially addressing affordability, access, or parity with other services.

Specific dollar amounts, percentage costs, caps, exemptions, or other numerical rules are not provided in the available information.

Who would be affected

Patients receiving physical therapy or occupational therapy services, particularly those with insurance coverage that requires copayments or coinsurance.

Health insurers and managed-care plans subject to state insurance laws.

Physical therapists, occupational therapists, and their practices that bill for PT/OT services.

State regulatory/legislative bodies overseeing insurance mandates and consumer protections.

Timeline and procedural context

Introduced: March 5, 2025

Referred to Insurance: May 5, 2025

Amendments and print version (6484A) issued: May 5, 2025

Reported and referred through Rules with CAL.569: May 20, 2025

Reported to Rules and Assembly floor actions culminated with “Ordered to Third Reading Rules CAL.569” in June 2025

This progression suggests the bill is moving through standard committee and floor procedures toward potential enactment.

Sponsors and related bills

Primary sponsor: David Weprin

Co-sponsors: Sarahana Shrestha, Jonathan Jacobson, Maritza Davila, Phil Steck, Rebecca Seawright

Related/companion bills: S 5045 (companion in a subsequent or different chamber)

Prior-session related bills include A 1063, A 1666, A 8171, A 405, A 594, A 6345, A 187, and their companion S 5045

Potential impact and considerations

Patients could see changes in out-of-pocket costs for PT/OT services, which may affect affordability and access to therapy.

Insurers and providers may need to adjust billing practices to comply with any new copayment/coinsurance rules.

The bill’s fiscal impact, enforcement mechanisms, and implementation timeline would be clarified in the full text and fiscal notes, which are not provided here.

If the full bill text becomes available, a more detailed section-by-section analysis (including any caps, exemptions, sunset provisions, or regulatory requirements) can be provided.

Bill