So, do I need a referral from a medical doctor in order to receive physical therapy treatment?
This question has both a simple answer and a more complicated one. The simple answer is NO, you do not need a prescription. As of January 1, 2015 all 50 states have some access to physical therapy without the need for a referral from a medical doctor. The complicated answer is NO, however there are state by state arbitrary restrictions limiting the access. This means, licensed physical therapists are able to legally treat anyone, however there are restrictions as to whether insurance will reimburse the clinic for the care given to the patient.
Here in Connecticut, Medicare and several other insurance companies require a prescription for physical therapy from a medical doctor prior to receiving treatment. There are other insurance companies requiring either a prescription or signed Plan of Care (POC) by a medical doctor, which the physical therapist will write and send to the appropriate doctor for signature. This is one reason it’s important to have a general practitioner (GP) familiar with your medical history. He/she will often be willing to sign off on physical therapy treatment without having to make a separate appointment prior to seeking physical therapy.
WHY IS THIS IMPORTANT?
Good quality healthcare is intrinsically patient-centered. It’s important that treatment is easily accessible and cost effective. Direct access decreases the time for you, the patient, to receive treatment, which improves your experience in various ways:
- Access to treatment while the pain or injury is acute (within 2 weeks of onset)
- Decreases chance of pain becoming chronic
- Lower overall cost to both you and the medical system
- Decreased number of appointments
- Decreased need for imaging and costly testing
- Lower rates of surgical interventions
- Faster recovery rates and improvement in symptoms
- Less need for pharmacological interventions
Do you have physical pain?
Make an appointment with your physical therapist today!
For details on your insurance plan requirements contact your physical therapy clinic for billing details as they will vary depending on your insurance benefits.
– Dr. Christopher Genn, PT, DPT, CSCS