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HB 3695

Relating to copayments required by a health maintenance organization or preferred provider benefit plan for visiting physical therapists.

89th Legislature (2025) Introduced by Jeff Barry and 37 co-sponsors

Bill regulates HMO and PPO copayments for physical therapy visits, likely capping or standardizing patient out-of-pocket costs to improve affordable access to rehabilitation services.

Committee report sent to Calendars
#healthmaintenanceorganizations(s0853) #healthcareproviders(i0387) #insurance--health&accident(i0422) #physicaltherapists(s6112)
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Bill Summary · HB 3695

Legislative bill overview

HB 3695 regulates copayment requirements that health maintenance organizations (HMOs) and preferred provider benefit plans can charge for physical therapy services. The bill specifically addresses what copayments patients must pay when visiting physical therapists, likely establishing limits or standardizing these costs across insurance plans in Texas.

Why is this important

Physical therapy is a frequently used healthcare service for injury recovery, post-surgical rehabilitation, and chronic pain management. Copayment regulations directly affect patient out-of-pocket costs and access to these services, particularly for individuals managing multiple therapy sessions—a common requirement for effective treatment.

Potential points of contention

  • Insurance industry concerns: Plans may argue that copayment restrictions limit their ability to manage costs and premiums, potentially leading to higher monthly insurance rates for all customers
  • Definition and scope ambiguity: Questions about whether protections apply equally to in-network and out-of-network therapists, and whether the bill covers all therapy types or specific conditions
  • Enforcement mechanism: Unclear how the state will monitor compliance and what penalties exist for violations, affecting practical implementation effectiveness

Compiled from official sources — confirm details with the bill’s official record.

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