FAQ: The Logistics of Initiating Physical Therapy

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Symmetry often gets asked how a patient can go about initiating Physical Therapy.  Here is a brief rundown of the way things currently work in Texas…

In Texas as of this writing, seeing a Physical Therapist for an Evaluation or Initial Consultation can be done WITHOUT a prescription.  All that needs to be done is to call to schedule an appointment.  It is almost always true that health insurances will provide reimbursement for physical therapy services without a referral.  Depending on your individual insurance plan, you would likely be responsible for a co-payment or a co-insurance for the visit.  Typically, this payment would be the same as you would pay for an outpatient office visit for other types of medical specialists.  The Symmetry team would be glad to help you find out precisely what PT benefits your individual insurance offers.

Physical Therapy treatment for visits after an Initial Evaluation in Texas still requires either a prescription or a signed approval of a physical therapy ‘plan of care’.  Generally, a prescription comes from a physician, though it can also come from a nurse, dentist, podiatrist, or chiropractor.  Your therapist can work with you to acquire this paperwork.  Depending on your particular issue, medical history, and relationship with your medical providers – requesting a prescription for therapy may or may not require an office visit to the referring practitioner.  Sometimes the request process is as simple as making a phone call and asking to have a prescription faxed.  We would be happy to make a request to acquire a PT prescription on your behalf.  In some cases, however, medical offices would prefer that their patients be the ones that initiate a referral request.

Specifically asking a medical practitioner for a prescription for Physical Therapy – either over the phone or when in the office – is completely appropriate.  Many medical professionals get very little training on what Physical Therapy is or how it works.  Because of this, their first inclination is often not to prescribe PT, but to instead offer medication, or perhaps suggest a trip to a specialist.  Know that a Physical Therapist IS a specialist.  And the medical literature on most orthopedic conditions currently supports Physical Therapy as an appropriate FIRST treatment – to see if a problem can be resolved without more intensive diagnostics (X-ray, MRI, etc.) or other medical procedures (injections or surgery, for example).   Physical therapy can be initiated quickly.  It is typical that an Initial Evaluation appointment can be scheduled with Symmetry within 1-2 business days.  In contrast – it is often true that the wait time for other medical specialists can be 2-4 weeks.  Because of this, it is often beneficial to patients to start physical therapy even if they also are in the process of waiting for a visit with another specialist.  There is no down side to improving musculoskeletal function while also working to determine if further treatment intervention is appropriate.

Another option besides asking for a prescription is to ask that a Physical Therapy Plan of Care be approved by your medical provider.  After Symmetry completes each initial evaluation assessment, we develop a plan for subsequent care.  We make recommendations about the specific services and number of visits that would be appropriate for each individual case.  We also develop treatment goals in conjunction with each patient, so that there is a specific ‘road map’ for how physical therapy will work to restore optimal function and normal activity. Symmetry summarizes all of this information into a document that is then sent to each patient’s medical provider.  When that provider signs the Plan of Care, it indicates that they agree with the treatment plan, and further physical therapy can then begin.  This option would be appropriate if a patient has chosen to complete an Initial Evaluation without already acquiring a prescription and would then like to continue with further formal treatment.

In many states besides Texas, it is possible to see a Physical Therapist for both evaluation and ongoing treatment without any requirement for a prescription or referral.  Being able to choose to see a physical therapist directly has been demonstrated to save patients time and often to improve the efficiency of their recovery from pain or injury.   Instead of waiting sometimes up to a several week interval prior to a medical appointment, patients in many states can start with rehabilitation fairly immediately after their symptoms start, which can eliminate or at least limit the development of secondary issues that then slow overall recovery rates.  Starting physical therapy soon after injury has also been demonstrated in many instances to lower the total medical cost of an episode of care.  Patients starting with physical therapy early tend to need less total visits to medical practitioners of all types and also tend to require fewer expensive diagnostic testing and other adjunctive treatment interventions.  They are able to address musculoskeletal issues before they result in major impacts on a patient’s normal function.

It is possible that there will be discussion of changing the regulations regarding the referral requirement for physical therapy during the current Texas Legislative Session.  As developments occur in the legislative arena, Symmetry will be staying informed and involved.  Watch this newsletter for further updates over the next several months.

We hope that this information is useful – even to those who have already been physical therapy consumers.  Please feel free to contact us if you have questions or would like further clarification about the Texas referral requirement for physical therapy.

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