Direct Access to Physical Therapy and Out-of-Pocket Costs

Did you know you can schedule an appointment with a physical therapist at Performance Therapies without seeing your doctor first? Even though Iowa has been a direct access state for Physical Therapy since 1988, I still meet quite a few people who think they need to be referred by a doctor in order to see a physical therapist. Yes, there are a few exceptions to this rule. If you have Medicare as your primary insurance provider then you do need a referral from your doctor before seeing your physical therapist. Almost every other private insurance provider will cover physical therapy without a doctor’s order. Direct access to physical therapy is possible because we are trained to identify potential medical issues or anything that that would require a visit to an MD. Scheduling with physical therapy first is a great cost and time savings to you, the patient.


Out-of-Pocket Cost
Out-of-pocket cost is another factor that deters some people from seeking the care of a physical therapist. There is a wide range of per visit out-of-pocket expense for each patient based on their insurance plan but in general co-pays have been decreasing.  Some plans do require you to meet your deductible before they will cover physical therapy and some do not. Our advice for anyone who is unsure about how their insurance plan covers physical therapy is to call the customer service number on the insurance card. I have had several patients who have come to their first PT visit that know they cannot afford the recommended amount of visits to treat their condition due to a high co-pay or high deductible that has not been met. It’s not always the ideal situation but I will gladly work with them to develop a home exercise program and we agree on a visit frequency that they can afford. I would much rather someone come in and tell me they can only afford 2-3 PT visits than have them sit at home suffering with pain or loss of function. We also have a cash pay rate for patients who don’t have insurance.


Performance Therapies Provides Solutions
If you are dealing with any muscle or joint pain, headaches, loss of strength,loss of function or balance, physical therapy can help. Call and schedule your appointment today! If you are not sure if your insurance provider requires a doctor referral, our office staff can typically answer that question when you call. If you are concerned about the cost of physical therapy, call your insurance provider and learn what is covered. If your out-of-pocket expense is unaffordable, let your physical therapist know at your first visit and together we can create a plan you are comfortable with. Your health and function are always a worthwhile investment.





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