What is Physical Therapy?


Physical Therapists (PTs) are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility - in many cases without expensive surgery and often reducing the need for long-term use of prescription medications and their side effects.
PTs examine each individual and develop a plan, using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.
Physical Therapists provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a Physical Therapist practices.

How to Access Physical Therapy

Not in most cases. In the state of Wisconsin, you can see a Physical Therapist without a referral from your doctor or other provider such as a Physician's Assistant or Nurse Practitioner. In addition, the vast majority of insurers do not require a referral from a doctor or other provider in order to pay for physical therapy services. Clinics who provide physical therapy are usually knowledgeable regarding which insurers in their area pay for direct access to a Physical Therapist. You can also check with your insurer yourself.

Call your doctor or other provider, tell them about your condition, and ask right away for a referral to physical therapy. Quite often, doctors or other providers will write a referral without the need for a clinic visit.

You have a right to choose your Physical Therapist. Your insurance, however, may pay differently for services received at "in network" versus "out of network" physical therapy clinics. If there is a Physical Therapist that you prefer or who has an area of expertise or specialization that you would like to see, many clinics and providers offer cash based services to anyone who walks in the door.

You can certainly still see a Physical Therapist! Many clinics offer cash based services at reduced rates. Remember, sometimes a visit or two with your Physical Therapist can reduce the need to see your doctor or get other medical interventions.

Some Physical Therapist specialize in treating certain types of conditions. A description of Physical Therapist specialization can be found here (link to page "what is a specialist"). Alternatively, when calling to make an appointment, ask directly about which therapist specializes in your condition.

Does My Insurance Cover PT?


Most insurance plans, including Medicare, workers' compensation, and private insurers, pay for physical therapy services that are medically necessary and that are provided by or under the direction and supervision of a Physical Therapist. Your Physical Therapist or your insurance company can tell you whether your insurance covers the recommended services and how much your out of pocket costs will be, if any.

 

What if your Physical Therapist is "out of network"

Most insurance companies, with the exception of Medicare and many HMOs, allow members to go "out of network" for health care services. Going out of network means that you can choose to see a Physical Therapist who is not a participating provider with your insurance company. In most cases, the amount paid by the insurance company will be less, and you will be responsible for paying the difference between what the Physical Therapist charges and what the insurance company pays. Many patients choose to receive services out of network in order to see the Physical Therapist of their choice. Your Physical Therapist can let you know in advance of your treatment what your out of pocket costs will be, if any.

 

What is Direct Access?

Direct Access refers to the removal of a physician referral mandated by state law to access physical therapy services for evaluation and treatment. Every state, the District of Columbia, and the US Virgin Islands allow for evaluation and some form of treatment without physician referral. For further information on Direct Access, click on the following link.

More on Direct Access

PT for My condition


Click on the link below to Access the American Physical Therapy Association's (APTA) website where you will find a list of medical conditions, additional information about the condition is, and how Physical Therapy can help with each condition without the need of additional pharmaceutical or surgical interventions.

Symptoms & Conditions

Specialty Areas in Physical Therapy


Similar to other health professions, Physical Therapists can specialize in certain practice areas. This involves learning content at a deeper level through continuing education as well as working frequently with patients with the types of conditions in which they specialize.

In some cases, the therapist decides to go through a standardized process to become a board certified specialist. The American Board of Physical Therapy Specialties (ABPTS) has certified more than 20,000 individuals who have demonstrated advanced clinical knowledge and skills in physical therapy specialty areas.

Currently, the ABPTS offers board-certification in nine specialty areas of physical therapy, with examples of the conditions a therapist may treat in each area of specialization:

  1. Cardiovascular and Pulmonary - patients with cardiovascular and pulmonary conditions, such chronic obstructive pulmonary disease or a heart transplant
  2. Clinical Electrophysiology - these therapist specialize in the use of electrotherapy and electrodiagnostics, such as nerve conduction studies (electromyelogram)
  3. Geriatrics - conditions that come with aging, such as osteoporosis and falls
  4. Neurology - neurological conditions such as stroke and traumatic brain injury
  5. Oncology - the effects of cancer itself as well as its treatments
  6. Orthopaedics - conditions such as low back pain, shoulder pain, and temporomandibular joint pain
  7. Pediatrics - movement related problems in children, such as cerebral palsy and congenital abnormalities
  8. Sports - sport and recreation related injuries such as knee injuries, ankle injuries
  9. Women's Health - sometimes called pelvic health, conditions such as incontinence and pelvic pain

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