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Understanding Payment for Physical Therapy Services

Physical therapists are professional health care providers who are licensed by the state in which they practice. You can check with your state agency overseeing physical therapy licensureto make sure that your physical therapist is licensed and in good standing or with the state’s physical therapy chapter. The following are common questions and answers pertaining to payment and insurance for physical therapy services.

Does insurance cover physical therapy services?

Most insurance plans, including Medicare, workers’ compensation, and private insurers, pay for physical therapy services that are medically necessary and provided by or under the direction and supervision of a physical therapist. Our front desk or your insurance company can tell you whether your insurance covers the recommended services and how much your out of pocket costs will be if any.

What if your physical therapist doesn’t participate in your insurance plan?

Most insurance companies, with the exception of Medicare and many HMOs, allow members to go “out of network” for health care services. Going out of network means that you can choose to see a physical therapist who is not a participating provider with your insurance company. In most cases, the amount paid by the insurance company will be less, and you will be responsible for paying the difference between the charges and what is paid by the insurance company. Many patients choose to receive services out of network in order to see the physical therapist of their choice. Our front desk will let you know in advance what your out of pocket costs will be.

What if you don’t have insurance?

If you don’t have health insurance that covers physical therapy services, you can still receive services by paying for them directly. If cost is a barrier, you may want to ask to modify your program to more of a self-treatment approach. Ask about our payment plans so you can get care when you need it most.

Are there services that physical therapists provide that are not covered by insurance?

Some physical therapists provide services that may not be covered by insurance plans. Examples of these services include personal training, sports performance enhancement, health education classes, and some prevention programs. Many individuals find these services to be valuable and pay out of pocket for them. Our front desk can let you know whether these services are covered by your insurance and give you information about the cost in advance.