Direct Access for Physical Therapy in California - How Does It Work?
Thanks to Direct Access legislation, physical therapy patients can now get evaluations and treatments directly from a licensed physical therapist (PT) without first obtaining a doctor's prescription or referral. It essentially means anyone can visit a physical therapist whenever they want.
Having Direct Access to physical therapy offers significant benefits for those who need care, as it saves time and money (since there's no need to see a primary care physician first). In addition, it often results in faster and better recoveries. However, the level of access varies by state and each individual's health insurance coverage. While all states offer some form of direct access to physical therapy, this article reviews the laws for California, the benefits, and how to easily obtain PT care in the state.
California's Direct Access Laws for Physical Therapy
California is one of the many states that allow Direct Access to physical therapy, but it comes with some provisions. A physical therapist can treat direct access patients in California when they:
- Recognize that the patient's care falls within their scope. If the therapist believes care isn't within their scope or the patient is not getting well, the PT must refer them to an appropriate healthcare provider.
- Notify the patient's doctor or surgeon that their patient is receiving physical therapy care. This notification occurs after the patient has provided the PT with written consent.
- Provide written or verbal notice to the patient (in at least 14-point font) outlining the receipt of direct physical therapy services. The notice must include and state that:
- The patient may continue receiving direct physical therapy treatment for up to 45 calendar days or 12 visits, whichever comes first.
- After 45 days or 12 visits, the therapist may continue patient treatment only with a patient-signed and dated plan of care. The plan of care must highlight the patient's consent and show that their physician conducted an in-person examination and evaluation. (Exceptions are made only if the PT provides wellness services or physical therapy services under a family service plan or individualized education plan (IEP) and the patient doesn't have a medical diagnosis.)
- A patient's signature.
- The PT understands they may not diagnose a disease.
- For tissue penetration, the physical therapist must have a referral and certification.
Note: After 12 visits or 45 days (whichever is first), the Luna team will work with your doctor to obtain a prescription if more visits or time is needed.
Please refer to the American Physical Therapy Association's Direct Access by State guide for any changes in California's direct access laws.
Benefits of Direct Access physical therapy
There are several reasons why it's beneficial for patients to have direct access to a PT. One is that they get more control over their care. Physical therapy is the obvious choice for certain conditions, like lower back pain, knee pain, tennis elbow, sciatica, and other PT conditions. Direct access gives patients a choice and lets them personally decide on their course of treatment. It's also less costly for patients since they can avoid paying for a doctor's visit (and pricey diagnostic tests) to get a referral. Moreover, patients don't have to wait to get the help they need. They can quickly schedule a visit with a licensed physical therapist right away, often reducing healing time. But even with direct access to physical therapy, it's understandable that patients still want and need their physicians, especially when coordinated care is required. At Luna, our physical therapists are happy to be a part of their patient's medical team and regularly communicate with their client's physicians to keep them aware of progress.
How to easily obtain physical therapy in California
Like many busy Americans, you'd likely prefer the convenience and privacy of in-home physical therapy. Luna is the top-ranking in-home physical therapy service. It provides state-of-the-art, immediate care to patients in need. In addition, Luna's easy-to-use platform makes the process effortless. Schedule an appointment, get matched with a top-notch licensed physical therapist, and receive high-quality care in your home, gym, or office at a time that works best for you.
The cost of getting physical therapy
The cost to get physical therapy is not as pricey as you may think. Physical therapy can be one of the best investments in your health. Plus, it can help you manage or avoid the high cost of chronic health issues. If you opt for the convenience of in-home physical therapy, it's often covered by insurance, the same as a PT clinic. For example, Luna accepts most insurances, including Medicare, Anthem Blue Cross, Aetna, Blue Shield of California, Cigna, Health Net, Humana, LA Care, Tricare, and UnitedHealthcare—in fact, all PPOs. And Medicare covers most (if not all) of the cost, and commercial insurance patients typically pay a small co-pay. Use Luna's online insurance coverage tool to see your benefits.
Today, thanks to direct access, you have two ways to receive PT care: through physician referral or by contacting a physical therapist directly. No matter which method you choose, try Luna's in-home physical therapy. You have nothing to lose and so much to gain -- and both you and your physician will love the excellent care you receive.