CAN I COME TO PHYSICAL THERAPY WITH OR WITHOUT A REFERRAL?
Physical therapy is a safe and affordable way to treat hundreds of different diagnoses, and a referral or prescription is not required to begin treatment – this is called direct access.
All 50 states including Vermont allows patients “direct access” to physical therapy services and programs without needing a physician’s prescription or referral. A major advantage to direct access is that patients see a decrease in their out-of-pocket costs by skipping a visit to their general practitioner for a referral. It also means that treatment can get underway faster. Direct access empowers you to take control of your health by choosing the best approach to your needs.
BENEFITS OF DIRECT ACCESS
Cost-Effective: By coming to physical therapy first, you avoid having to pay for a visit to the doctor – which can save you, your insurance company, and the healthcare system money. Oftentimes physical therapy can also reduce the need for alternative treatment methods such as medication, injections, and imaging.
Quicker Results: When you’re in pain, you want relief fast, but sometimes it can take weeks to get in to see the doctor. In the meantime, you may begin taking over-the-counter medications or go to the emergency room or urgent care for pain relief. With direct access to physical therapy, you’ll spend less time and effort scheduling a physician’s visit and begin feeling better faster.
Higher Patient Satisfaction: Numerous studies have shown that direct-access patients report higher satisfaction levels than those with a referral. Even though patients may have received identical treatment, the ability to begin physical therapy immediately led to quicker recovery – this plays a key role in higher satisfaction levels.
You have control over your health! You know your body better than anyone else. When you’re in pain or have been injured and feel that you could benefit from physical therapy, you should be able to decide where and how to seek treatment, and direct access allows you to do just that.
DIRECT ACCESS FAQS
What’s the difference between direct access to physical therapy and referral-based physical therapy?
Direct access to physical therapy means that a patient can receive physical therapy treatment without a referral from a physician, while referral-based physical therapy requires a referral from a physician before treatment can begin.
Will insurance cover therapy if I’m not referred?
Vermont is a Direct Access State, but your insurance company may or may not allow it depending on your policy. It’s best to check with your insurance provider to determine if physical therapy treatment is covered under your plan. If you have any questions, our patient coordinator will help you. Medicare, Medicare Replacement, Medicaid, Worker’s Comp, and Auto Injury Plans still require a referral to be covered by your plan.
Will my physical therapist still communicate with my primary care physician if I’m a direct access patient?
Yes, as part of your healthcare team, we want to keep an open line of communication. Please notify us who you would like your information faxed to. We will not send any information to anyone without your consent.
What should I expect during my initial evaluation as a direct access patient?
During the initial visit, your therapist will conduct a thorough evaluation of your condition and develop a treatment plan. This may include exercises, manual therapy, and other techniques to help manage your symptoms and improve your function.
Does direct access to my physical therapist cost more?
No, there is no additional cost for direct access patients.
How does direct access help me?
The previous therapy referral mandate caused delays for people benefitting from physical therapy treatment. Those delays often resulted in higher healthcare costs, lower functional outcomes, and frustration to patients who wanted to get in for physical therapy treatments sooner. By eliminating the referral mandate, patients can start treatment faster.
Why is direct access beneficial?
There’s no denying that healthcare is expensive. When you can directly seek the services of a physical therapist can help save healthcare dollars by reducing doctor visits and potentially eliminating certain medications, surgeries, and imaging tests like