89R239 CJD-D
By: Orr H.B. No. 3695
A BILL TO BE ENTITLED
AN ACT
relating to copayments required by a health maintenance
organization or preferred provider benefit plan for visiting
physical therapists.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter F, Chapter 843, Insurance Code, is
amended by adding Section 843.212 to read as follows:
Sec. 843.212. PHYSICAL THERAPIST COPAYMENT LIMIT. A health
care plan that requires an enrollee to pay a copayment for an office
visit with the enrollee's primary care physician or provider may
not charge a higher copayment amount to that enrollee for an office
visit with a physical therapist if that visit did not require a
referral from a physician or provider.
SECTION 2. Subchapter D, Chapter 1301, Insurance Code, is
amended by adding Section 1301.167 to read as follows:
Sec. 1301.167. PHYSICAL THERAPIST COPAYMENT LIMIT. A
preferred provider benefit plan that requires an insured to pay a
copayment for an office visit with the insured's primary care
physician or provider may not charge a higher copayment amount to
that insured for an office visit with a physical therapist if that
visit did not require a referral from a physician or health care
provider.
SECTION 3. The changes in law made by this Act apply only to
a health benefit plan delivered, issued for delivery, or renewed on
or after January 1, 2026.
SECTION 4. This Act takes effect September 1, 2025.