FAQ

The State of California does allow direct access to physical therapy without a referral. The physical therapist must have earned a Doctorate of Physical Therapy (DPT) degree and have a minimum of three years of full-time experience to be able to treat patients without a referral. Under Direct Access laws, patients are allowed ten sessions or 30 days of treatment without a referral, whichever comes first, before they are required to have a prescription. Most insurances cover direct access to physical therapy, and they generally will reimburse for a visit, even if the patient does not have a prescription. However, some insurances, most notably Medicare and Workers’ Compensation, require a prescription, and these prescriptions must be updated regularly. Contact us if you have any questions or concerns about whether your insurance will cover your direct access to physical therapy treatments.

To learn more about what might happen during your first visit to PRO~PT, check out our blog.

Make sure you bring your physical therapy referral (provided to you by your doctor) and your payment information. If your insurance is covering the cost of physical therapy, bring your insurance card. If you are covered by Workers’ Compensation, bring your claim number and your case manager’s contact information. If you are covered by auto insurance or an attorney lien, make sure you bring this information

You should wear loose-fitting clothing so you can expose the area that we will be evaluating and treating. For example, if you have a knee problem, it is best to wear shorts. For a shoulder problem, a tank top is a good choice, and for low back problems, wear a loose-fitting shirt and pants.

Treatment sessions typically last 30 to 60 minutes per visit.

This is highly variable. You may need one visit, or you may need months of care. It depends on your diagnosis, the severity of your impairments, your past medical history, etc. You will be reevaluated on a monthly basis, and when you see your doctor, we will provide you with a progress report with our recommendations.

More than half of all Americans are suffering from pain. Whether it is a recent episode or chronic, an ABC News/Stanford study revealed that pain in America is a serious problem. However, many do not even know that physical therapists are well equipped to treat not only pain but also its source.

Physical therapists are experts at treating movement and neuro-musculoskeletal disorders. Pain often accompanies a movement disorder, and physical therapists can help correct the disorder and relieve the pain.

Learn more about what physical therapists do by reading our blog.

You may be referred to physical therapy because of a movement dysfunction associated with pain. Your difficulty with moving part(s) of your body (like bending at the low back or difficulty sleeping on your shoulder) very likely results in limitations with your daily activities (e.g., difficulty getting out of a chair, an inability to play sports, or trouble with walking, etc.). Physical therapists treat these movement dysfunctions and their associated pains, restoring your body’s ability to move in a normal manner.

In most cases, health insurance will cover your treatment. Click on our insurance link above for a summary of insurances we accept and make sure you talk to our receptionist so we can help you clarify your insurance coverage.

You will be evaluated by one of our licensed and highly trained physical therapists, and he/she will also treat you during subsequent visits. Unlike some clinics, where you see someone different each visit, we feel it is imperative to develop a one-on-one relationship with you to maintain continuity of care. Since only one physical therapist knows your problems best, he/she is the one that will be working closely with you to speed your recovery.

Learn more about physical therapy specialists by reading our blog.

For many patients, one of the primary objectives is pain relief. This is frequently accomplished with hands-on techniques and modalities such as ultrasound, electrical stimulation, and/or heat/cold therapy. Movement often provides pain relief, as well. Your physical therapist will provide you with the appropriate exercises not only for pain relief but to recover range of motion, strength, and endurance.

In some cases, physical therapy techniques can be painful. For example, recovering knee range of motion after total knee replacement or shoulder range of motion after shoulder surgery may be uncomfortable. Your physical therapist will utilize a variety of techniques to help maximize your treatment goals. It is important that you communicate the intensity, frequency, and duration of pain to your therapist. Without this information, it is difficult for the therapist to adjust your treatment plan.

Learn more about the types of treatments we perform at PRO~PT by reading our blog.

Massage may be part of your treatment. Rehabilitation specialists are trained in a variety of techniques that may help with your recovery. Deep tissue techniques may be part of the rehabilitative process. Massage is used for three reasons typically—to facilitate venous return from a swollen area, to relax a tight muscle, or to relieve pain. Contrary to common thought, massage does not increase circulation.

Flare-ups are not uncommon. If you have a flare-up (exacerbation), give us a call. We may suggest you come back to see us, return to your doctor, or simply modify your daily activities or exercise routine.

In most cases, you have the right to choose any physical therapy clinic. Our practice is a provider for many different insurance plans. The best thing to do is give us a call, and we will attempt to answer all of your questions.

All fifty states have some form of direct access. In most cases, if you are not making significant improvement within 30 days, the therapist will refer you to/back to your physician. Seeing a physical therapist first is safe and could save you hundreds of dollars or even thousands of dollars.

Billing for physical therapy services is similar to what happens at your doctor’s office. When you are seen for treatment, the following occurs:

1. The physical therapist bills your insurance company, Workers’ Comp, or charges you based on Common Procedure Terminology (CPT) codes.
2. Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer.
3. The payer processes this information and makes payments according to an agreed-upon fee schedule.
4. An Explanation of Benefits (EOB) is generated and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient.
5. The patient is expected to make the payment on the balance, if any.

It is important to understand that there are many small steps (beyond the outline provided above) within the process. Exceptions are common to the above example, as well. At any time along the way, information may be missing, miscommunicated, or misunderstood. This can delay the payment process. While it is common for the payment process to be completed in 60 days or less, it is not uncommon for the physical therapy clinic to receive payment as long as six months after the treatment date.

Some patients will need to continue with home exercises. Some may choose to continue with a gym exercise program. Others will complete their rehabilitation and return to normal daily activities. It is important that you communicate your goals to your therapist so that they can develop a customized program for you.

Physical therapists (PTs) and physical therapist assistants (PTAs) are licensed by their respective states.

These are some things you may consider when seeking a physical therapy clinic:

• The therapist should be licensed in the state.
• The first visit should include a thorough medical history and physical examination before any treatment is rendered.
• The patient goals should be discussed in detail during the first visit.
• Care should include a variety of techniques that might include hands-on techniques, soft tissue work, therapeutic exercises, and in some cases, heat, cold, electrical stimulation, or ultrasound.
• Do they have a service that can address your problem?
• Do they take your insurance, or are they willing to work with you if they are not a preferred provider?
• They should be conveniently located. Since sitting and driving can often aggravate orthopedic problems, there should be a very good reason for you to drive a long distance for rehabilitation.
• What are the hours of operation?
• Can they provide satisfaction survey results?
• The therapist should provide the treatment.
• Can you briefly interview the therapist before the first visit?
• Ask your family and friends who they would recommend.

Our privacy policy can be read here.

An appointment is required for all of our locations. You can quickly request an appointment online and a member of our staff will be in touch with you shortly.

The state of California allows direct access to physical therapy treatment — no referral required. After 10 visits or 30 days, your insurance may require a prescription for continued treatment.

If you have any concerns about whether or not your insurance will cover your visits, please contact us.

• Your physical therapist should be licensed.
• Your physical therapy clinic should have reviews that reflect positive client experiences. Do your homework and call local clinics to learn about services they offer, what to expect at your first appointment, and make sure they are a good fit for you.
• The clinic you visit should be conveniently located — driving long distances can aggravate many of the orthopedic issues we see on a regular basis.

The cost of your physical therapy treatment will vary based on your treatment plan, the number of sessions required, and your specific goals.

At PRO~PT, we are committed to transparency. We will help you understand your financial estimate associated with your treatment plan and what portion will be covered by your insurance before you begin your treatment.