When it comes to receiving physical therapy or other forms of healthcare, cost is often top of mind. You may wonder how much insurance companies pay for physical therapy, and if they do, what the reimbursement rates are.
Those are fair questions. The good news is, yes, most insurance plans, including Medicare, private insurers, and workers’ compensation pay for “medically necessary” PT services provided by or under the supervision of a physical therapist, according to the American Physical Therapy Association (APTA). Your PT or insurance company can tell you what services your policy covers—and what your out-of-pocket costs could be.
Minding the Insurance Gaps
Your physical therapist might be out “out-of-network,” which means they aren’t a participating provider with your insurance company. If that’s the case, your insurer will likely pay less for the treatment. You’ll be responsible for paying the difference between what your PT charges and what the insurance company pays. Again, your physical therapist can let you know ahead of time what your out-of-pocket costs will be.
If you don’t have insurance, you can still receive treatment by paying directly, called self-pay. For example, the typical self-pay cost per session is $125 at Luna (without insurance), but what you actually pay can depend on where you live and the type of therapy you need.
3 Ways to Get the Most from Your Insurance Coverage
If you’re not happy with the insurance you have, don’t worry. The experts at GuideDoc share eight strategies for maximizing insurance coverage for physical therapy services. A few of these include:
Review your policy. By knowing exactly what’s in your policy— fine print included—you have an advantage when asking your insurer to pay for PT treatment.
Be proactive. You have the right and responsibility to manage your own healthcare. This includes the right to consent to treatment and to be thoroughly informed about all the physical therapy choices being presented to you.
Know your physical therapist. The right physical therapist can be your best ally for maximizing coverage. They have a lot of experience working with insurance companies and may be able to use their authority and expertise as a medical professional on your behalf.
Does Insurance Cover On-Demand Physical Therapy?
If like many busy Americans, you prefer the convenience and privacy of on-demand physical therapy, there’s good news. Insurance companies will often cover on-demand PT the exact same way they do PT in a clinic setting.
For example, Luna accepts most insurances, including Medicare, Anthem Blue Cross, Aetna, Blue Shield of California, Cigna, Health Net, Humana, LA Care, Tricare, 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. Learn more about Luna’s on-demand physical therapy today.
