Overview
KEY UPDATE
Illinois enacted HB 5087, which significantly limits physical therapists’ ability to provide telehealth services to patients in the state. As enacted, these new provisions become effective on January 1, 2025. In this article, we discuss the new legislation and its impact on telehealth providers and patients in further detail.
LEGISLATIVE UPDATE
Under the enacted legislation, effective on January 1, 2025, the Illinois Physical Therapy Act is amended by adding a new section, 225 ILCS 90/1.3, regarding telehealth services.
This new section requires that physical therapists (or physical therapist assistants working under the general supervision of a physical therapist) that provide physical therapy through telehealth services pursuant to the terms and use defined in the Telehealth Act and the Illinois Insurance Code are additionally subject to the following conditions:
- Initial physical therapy evaluations without a referral or established diagnosis may only be performed by a licensed physical therapist and cannot be performed via telehealth unless necessary to address a documented hardship, including but not limited to geographical, physical, or weather-related conditions.
- The use of telehealth as a primary means of delivering physical therapy must be an exception, and documentation must support the clinical justification.
- A patient receiving physical therapy must be able to request and receive in-person care at any point during their treatment.
- A physical therapist providing telehealth must have the capacity to provide in-person care within the state of Illinois.
WHY IT MATTERS
- The above conditions significantly increase the barriers for both telehealth providers and patients seeking remote telehealth physical therapy services.
- The legislation introduces new requirements, such as prohibiting telehealth unless there is a documented hardship such as physical, geography or weather-related hardships, but does not further elaborate on how such hardships should be evaluated or documented (if at all). Requiring this heightened standard poses significant barriers to the delivery physical therapy via telehealth to Illinois patients.
- The additional requirement for providers to have the capacity to provide in-person care within the state of Illinois significantly limits many remote physical therapy providers who are otherwise licensed and duly authorized to practice within the state of Illinois, by requiring them to offer a physical space in which to offer care or to arrange for such accommodations – thus decreasing patient access to otherwise authorized physical therapy providers that can provide these beneficial services to patients in need.
- While the enacted legislation does not address payors, carriers should closely evaluate and update their current coverage and reimbursement policies related to physical therapy provided via telehealth to align with the new standards in Illinois. Likewise, providers should assess the impact of these restrictions on their current practice.
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Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott digital health team works alongside the industry’s leading providers, payors, and technology innovators to help them enter new markets, break down barriers to delivering accessible care, and mitigate enforcement risk through proactive compliance. Are you working to make healthcare more accessible through telehealth? Let us help you transform telehealth.
