Primary Care Physical Therapy

When to ask a physical therapist

When you have a problem that limits your movement or physical activity, a physical therapist can help. Physical therapists are licensed health care professionals. They are the providers of choice to restore function and movement for people with many conditions, including those affecting muscles, joints, bones, or nerves. Physical therapists help people safely manage pain and recover from injury, illness, or surgery. They also can help you prevent and improve many chronic conditions. Some physical therapists also offer fitness and wellness services.

But health care can seem expensive, and you may have concerns about whether your insurance will cover your visits. Whatever your reason for needing physical therapy, knowing how to access care is helpful. It also is important to understand how payment for physical therapist services works.

Do I need a referral from my doctor?

Primary care providers and surgeons often refer their patients to see a physical therapist when needed. You also can request a referral. Talk to your physician, nurse practitioner, or physician’s assistant about how physical therapy can help you.

You also can go straight to a physical therapist without a referral. All states and the District of Columbia allow direct access to a physical therapist.

Will my insurance pay for direct access PT?

Depending on your benefits, your plan may cover physical therapy in full or in part. Many plans limit your out-of-pocket cost for each visit to a copayment. Others require you to pay for part or all of your visits until you have reached your deductible. After that, the insurance plan pays 100% up to its set limit. Some insurance companies classify physical therapists as specialists. Certain plans require you to get a referral from your primary care provider before they will pay for any specialist’s services.
You should always check with your insurance before starting a plan of care for an explanation of benefits. We are your partners in healthcare and can also confirm your benefits with the insurance company after your evaluation.

What if I don't have insurance?

In many cases, a physical therapist can help you in just a few visits. Without insurance, or if your plan does not cover physical therapy, you can still see a physical therapist by paying directly. This is called self-pay or cash-based. Self-pay is also an option if you choose to see a provider who is not in your health plan’s network. Ask your physical therapist the exact cost of each visit.