Think you need a referral from a physician to see a physical therapist? Well, think again! Every state allows for evaluation and treatment from a physical therapist without a doctor’s referral with Direct Access legislation. Eliminating barriers results in more effective and quicker healthcare. Think about it. You wake up with an aching back that gets worse instead of better. You call the doctor and discover that you can’t be seen for three more days. That’s three more days of pain. With Direct Access to a physical therapist, you can see a physical therapist today and jump-start your recovery. The sooner you get to see a PT, the sooner you’ll be on the road to feeling better. Plus, it saves you money and allows you to get back to your regular lifestyle more quickly. Direct Access is all about making personal choice without regulations. It puts you in the driver’s seat of your own healthcare.
Which Insurance Plans Cover Direct Access?
Although insurance is always changing Cigna, Blue Cross Blue Shield and many private health insurance companies are covered under Direct Access. As long as the physical therapist establishes a plan of care for the patient, care is covered under Medicare. Just keep in mind that for continued treatment, the physical therapist must have the plan of care approved and signed off by a licensed doctor.
Debunking Some of the Myths About Direct Access
Many people think that Direct Access only applies to private outpatient physical therapy treatments but it also applies to treatment in pediatric centers, private home care, school systems, hospitals and on the sports field. Direct Access is much more commonplace than what people realize.
Another myth is that Direct Access doesn’t exist in all states. The truth is that Direct Access is available in some form in all 50 states, including the District of Columbia. There may be some limitations for Direct Access, however, the groundwork has been laid and the rules will be shifting in the future.
Studies About Direct Access in Physical Therapy Have Shown That:
- Patients reported a higher level of satisfaction when they received physical therapy through Direct Access versus physician referral.
- Patients receiving physical therapy through direct access versus referral had better outcomes at discharge.
All around, Direct Access is changing the landscape of healthcare.
Q. What exactly does Direct Access mean?
A. Direct Access means you may choose where you receive physical therapy and you can do so without a physician order. This can save you the extra expense of an office visit.
Q. If I come to physical therapy Direct Access, does this mean my physician won’t be involved?
A. The choice is yours! When you come Direct Access, you may ask us to include your family physician or any other provider that is involved in your care. We are happy to send regular updates to the provider of your choice.
Q. How long can I attend therapy as a Direct Access patient?
A. In July 2019, Indiana expanded Direct Access from 24 to 42 calendar days!
Q. If I come to the end of the 42 days of Direct Access, will I have to discontinue therapy?
A. No, with your permission, we will reach out to your family physician and update them on your progress. We will request an order to continue physical therapy at that time.
Q. Will my insurance cover physical therapy if I come Direct Access?
A. Yes, most insurance companies recognize Direct Access laws and cover physical therapy services without a physician order. Typically, when insurance coverage is verified, the insurance company usually indicates if the insurance policy requires an order. If that is the case, we will work with the physician of your choice to obtain the order.
Q. I have Medicare, may I come Direct Access?
A. Yes, Medicare patients may come to physical therapy Direct Access. Once the physical therapy evaluation is complete, it will be sent to your physician. Medicare does not require a physician order but does require the physician signature on the physical therapy plan.
