Physical therapy and occupational therapy benefit in the Medicare annual wellness visit and initial preventive physical exam

(a) Annual wellness visit (1) In general Section 1861(hhh) of the Social Security Act (42 U.S.C. 1395x(hhh)) is amended— (A) in paragraph (1)— (i) in subparagraph (A), by striking; and and inserting a semicolon; (ii) in subparagraph (B)(ii), by striking the period at the end and inserting; and; and (iii) by adding at the end the following new subparagraph: (C) that, in the case of an individual who has been determined by a physician to have fallen in the previous calendar year, includes a falls risk assessment and fall prevention services.; and (B) in paragraph (3)— (i) in subparagraph (B), by striking or at the end; (ii) in subparagraph (C), by striking the period at the end and inserting; or; and (iii) by adding at the end the following new subparagraph: (D) in the case of an individual described in paragraph (1)(C), a physical therapist or an occupational therapist furnishing a separate falls risk assessment and fall prevention services.. (2) Effective date The amendment made by paragraph (1) shall apply to annual wellness visits furnished on or after January 1, 2026. (b) Initial preventive physical examination (1) In general Section 1861(ww)(2) of the Social Security Act (42 U.S.C. 1395x(ww)(2)) is amended— (A) in subparagraph (N), by moving the margins of such subparagraph 2 ems to the left; (B) by redesignating subparagraph (O) as subparagraph (P); and (C) by inserting after subparagraph (N) the following new subparagraph: (O) In the case of an individual that has been determined by a physician to have experienced a fall in the previous calendar year, outpatient occupational therapy services (as defined in subsection (g)) and outpatient physical therapy services (as defined in subsection (p)).. (2) Effective date The amendment made by paragraph (1) shall apply to initial preventive physical examinations furnished on or after January 1, 2026.