As a physical therapist I frequently get asked by people that are dealing with an injury, “well how do I get an appointment with you, do I need a prescription or a physical therapy referral?”. The world of insurance can be a very confusing thing for the consumer. At Quincy Physical Therapy our front office does their best to explain and break down how your individual insurance works before you even start your first visit. We want to make things as easy as possible to get you started in our clinic and provide quality care. Several insurance plans including Medicare and other PPO’s (preferred provider organizations) are considered to be direct access and the state of MA allows for direct access
Many people don’t know that MA is a direct access state. This means that if you need physical therapy you don’t need a referral from your doctor. You can come in for treatment on your own. So you can refer yourself, just call our clinic and we will schedule you as soon as possible for an evaluation. At Quincy Physical Therapy we are all doctors of physical therapy. DPT’s are highly-trained in how to recognize “red flags” and refer out to physicians immediately if needed. DPT’s learned the proper screening tools to deem if you are appropriate for therapy. We will refer you out to a physician for possible diagnostic imaging to rule out a pathology that is not appropriate for therapy. With direct access the APTA enabled PT’s to be the preferred licensed professionals to treat musculoskeletal disorders.
Direct access is a way to save money for not only the insurance company but the consumer as well. Many insurance companies now recognize the cost savings and improved access to care that come with direct access and do not require a referral for payment1. For example: these savings are evident in the area of low back pain costs. Chronic low back pain is a high cost in the healthcare industry and by getting early access we can save over 50% in cost. If a patient receives physical therapy within 14 days of onset of pain it can minimize the average total cost of care by 50%2. That is major savings for the health care industry and for the individual by getting a patient in physical therapy the following day after their injury and starting treatments like dry needling, spinal manipulation, and corrective exercises.
Without the need for a physical therapy referral the option to choose where you want to go for treatment is much easier. You don’t have to wait to book an appointment with your PCP or an orthopedic doctor which can sometimes take weeks. At Quincy Physical Therapy we can typically get patients in within 24 hours of calling, if they have a flexible schedule. We even offer FREE Discovery Visits! A discovery visit is a free consultation with a therapist for a potential patient to come into the clinic and discuss their current condition and see if physical therapy is something that can help them. Frequently the discovery visit leads to the patient being a formal patient. We have therapists trained in spinal manipulation, dry needling, vestibular rehab, and modern strength training. So it’s that easy to save money and get quality care! Feel free to book an appointment for either a free discovery visit or for your initial evaluation today at 617-481-2000.
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4 thoughts on “Do I Need A Referral to Come to Physical Therapy?”
It’s a good point that without a referral, it’s a lot easier to find a local therapist that you want to visit. My brother is trying to get some PT this month for his back pain. He needs to find a professional that will work with his insurance for lower rates.
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I loved it when you said that many people don’t know that MA is a direct access state. This means that if you need physical therapy you don’t need a referral from your doctor. I have been experiencing back pain near my limbs lately. I should look for an occupational therapist before it gets complicated. This article is an excellent help to me.