Physical therapy (PT) is typically a covered service under most insurance plans as it is considered medically necessary in the treatment of injury, illness, and for post-operative rehab.
Depending on the type of insurance you have, the coverage you have for physical therapy utilization will vary. When selecting a physical therapy provider, the status of the provider as an “in-network” versus “out-of-network” provider can also affect how your insurance will play a role in payment for services.
Deciding between In-Network and Out-of-Network
While on the surface, it appears that going out-of-network can be a more costly decision for physical therapy, but taking a closer look at a total course of care and what you are getting as a patient reveals a different story. Let’s take the following as an example: A patient is prescribed physical therapy 3x per week for 6 weeks, here are two routes they may take.
In-Network PT Provider
Out-of-Network PT Provider
Many factors go into deciding which provider to choose for physical therapy. While one of the most common questions patients have is “do you take my insurance,” a provider that takes your insurance may end up being more expensive and being unable to provide you with the same one-on-one care that you will find with an out-of-network provider. The time, dedication, and individual focus you will receive from an out-of-network provider is well worth the investment to ensure you’re getting the best care that’s available when you’re in need of PT.