The short answer: On October 1, 2026, New Jersey’s Department of Banking and Insurance (DOBI) proposed replacing the current $105-per-day NJ PIP rehab cap with a $1,015-per-week cap. If adopted, the change would raise what PIP pays for physical therapy and rehabilitation after a car accident by roughly 38% and let you see more than one provider on the same day. This is a proposal, not a final rule. Public comments are open until October 15, 2026.
What the Current NJ PIP Rehab Cap Does
New Jersey is a no-fault auto insurance state. That means your own Personal Injury Protection (PIP) coverage pays your medical bills after a car accident, no matter who caused the crash.
But PIP does not pay unlimited amounts for every service. For Physical Medicine and Rehabilitation — the billing category that covers physical therapy, occupational therapy, and related rehab services — PIP currently pays at most $105 per day. This daily maximum comes from N.J.A.C. 11:3-29.4(m), part of New Jersey’s PIP medical fee schedule.
In practice, the daily cap creates a hard ceiling on your treatment day. If your physical therapist bills $80 for a session and your occupational therapist bills $60 for the same day, the combined $140 exceeds the $105 cap. Something has to give: either a service gets cut, you pay the difference out of pocket, or your providers adjust the billing. For people with serious injuries who need multiple types of therapy, the daily cap can quietly shape — and limit — the care they receive.
What DOBI Is Proposing
DOBI’s advance notice of rulemaking, issued October 1, 2026, would amend N.J.A.C. 11:3-29.4(m) to remove the $105 daily maximum and replace it with a $1,015 weekly maximum for the same Physical Medicine and Rehabilitation CPT codes.
The numbers break down like this:
- Current cap: $105 per day
- Proposed cap: $1,015 per week
- Effective daily equivalent: about $145 per day ($1,015 divided by 7)
- Increase: roughly 38% over the current daily rate
The proposal also defines “weekly” for the first time in this context. A new definition in N.J.A.C. 11:3-29.2 would set the week as seven calendar days, running Sunday through Saturday.
The biggest structural change is flexibility. Under the daily cap, all of your rehab billing for one day had to fit under $105, no matter how many providers treated you. Under a weekly cap, the $1,015 applies across the full week. According to DOBI, this would let injured claimants get same-day treatment from different providers for injuries from the same accident — and allow additional procedures to be performed within the week.
One thing that would not change: National Correct Coding Initiative (NCCI) edits would continue to govern billing. These are the federal coding rules that prevent providers from unbundling services that should be billed together. The weekly cap raises the ceiling; it does not remove the billing rules underneath it.
What Changes for You After a Crash
If the rule is adopted, three practical things change for New Jersey drivers:
1. More room for same-day treatment. Many accident injuries need more than one kind of rehab in a single day — physical therapy in the morning, occupational therapy in the afternoon. The weekly cap gives your providers room to bill for both without hitting a daily wall.
2. Fewer billing-driven treatment decisions. Under the daily cap, providers sometimes have to choose which service to bill on a given day. That is a billing decision, not a medical one, but it can affect your care plan. A weekly cap reduces that pressure.
3. Higher total reimbursement for rehab. The roughly 38% increase means PIP covers more of the real cost of rehabilitation. That matters because unpaid balances do not disappear — they can become your problem.
What would not change: the proposal does not raise your overall PIP policy limits, does not change which injuries qualify for PIP, and does not affect the rest of the PIP fee schedule. It is a targeted change to one billing category.
What Has Not Changed Yet
This is the part that matters most right now: nothing has changed yet.
DOBI issued an advance notice of rulemaking, not a proposed rule and not a final rule. An advance notice is the earliest stage of the process — the agency describing what it is considering and asking for public input before it formally proposes anything.
That means:
- The $105 daily cap is still the law today.
- Adoption of the weekly cap is not guaranteed.
- Even if DOBI moves forward, there will be a formal proposal, another comment period, and an adoption process before anything takes effect.
If you are treating under PIP right now and running into the daily cap, the current rules still apply to your bills. The rules on what PIP must pay are technical, and billing mistakes can cost you — if your rehab bills look wrong, talk to an attorney who handles New Jersey injury claims.
This is also a good moment to review your own coverage. New Jersey raised its minimum auto insurance limits in 2026, and the choices you make on your policy — including your PIP limits — determine what is available to you after a crash. Our earlier breakdown of New Jersey’s 2026 auto insurance law changes walks through what changed and what to check.
Public Comments: How to Weigh In Before October 15
DOBI is asking for input before it formally proposes the rule. Comments should be emailed to AdvanceNotice@dobi.nj.gov by October 15, 2026.
Anyone can comment — patients, providers, and practitioners. If the daily cap has affected your treatment or your practice, this is the window to say so on the record. After the comment period, DOBI will decide whether to move forward with a formal proposal.
Frequently Asked Questions
What is the current PIP rehab cap in New Jersey?
PIP currently pays at most $105 per day for Physical Medicine and Rehabilitation services under N.J.A.C. 11:3-29.4(m). This daily maximum applies to a defined group of CPT codes billed through your auto PIP coverage after an accident.
What is New Jersey proposing to change about the NJ PIP rehab cap?
DOBI has proposed replacing the $105-per-day cap with a $1,015-per-week cap (measured Sunday through Saturday). The weekly figure works out to about $145 per day — roughly a 38% increase — and would allow same-day treatment from different providers for the same accident.
Is the weekly PIP cap a final rule?
No. As of October 2026, it is an advance notice of rulemaking — the earliest stage of the regulatory process. Public comments are due October 15, 2026. Even after that, DOBI must issue a formal proposal with its own comment period before any rule can be adopted.
Would the weekly cap change my PIP policy limits?
No. The proposal only changes the maximum allowable fee for one billing category (Physical Medicine and Rehabilitation CPT codes). It does not change your overall PIP coverage limits, which injuries qualify, or any other part of the PIP fee schedule.
What should I do if my rehab bills are hitting the daily cap now?
The $105 daily cap is still in effect. If your bills seem wrong or your treatment is being limited by billing rather than medical need, speak with a New Jersey personal injury attorney. For background on how injury claims work generally, see Understanding Personal Injury Claims.
Talk to a New Jersey Injury Attorney
If you were hurt in a car accident in New Jersey and have questions about your PIP benefits, your rehab bills, or your injury claim, contact Aburas Law, LLC at 862-213-9093 or visit aburaslaw.com for a consultation.
Reviewed by Ahmad Aburas, Esq.
Attorney Advertising. This article is for general informational purposes only and does not constitute legal advice or create an attorney-client relationship. Laws change and every situation is different. Please contact an attorney about your specific circumstances. Prior results do not guarantee a similar outcome.
