Back to Insights and Updates for ProvidersAugust 2023

Billing reminder for pelvic floor therapy

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As a reminder, Point32Health provides coverage for treatment of pelvic floor disorders. Members are eligible to receive clinical evaluation and physical therapy (PT) as outlined in their plan benefits. When billing for PT for pelvic floor disorders, providers should use diagnosis code 090.89.

Prior authorization is not required for Harvard Pilgrim Health Care members in need of pelvic floor physical therapy. For Tufts Health Plan members, prior authorization requirements vary. Refer to the applicable Medical Necessity Guidelines for details.

Additional billing information can be found within the Harvard Pilgrim Health Care Physical, Occupational, and Speech Therapy Payment Policy as well as the Tufts Health Plan Commercial, Medicare Preferred and Senior Care Options (SCO), and Tufts Health Plan Public Plans Physical, Occupational, and Speech Therapy Professional payment policies.

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