New Horizons Physical Therapy

Question	Answer
What are the general insurance requirements to receive physical therapy (PT)?	All insurance companies differ in this respect. Here are some things you should ask your insurance company prior to coming to your first PT appointment: Do they require PRE-AUTHORIZATION, even if you have a doctor’s prescription for PT? Do they even require that you see a physician to get a prescription for PT? Do they have limits or restrictions on the number of visits you may receive in a given time frame? What is your deductible?

What are the Medicare requirements to receive PT?	Medicare REQUIRES the following in order for you to receive PT: You MUST see your doctor during a SCHEDULED appointment to receive your first prescription for PT. Schedule your first PT visit within 30 DAYS of receiving this first prescription, or else it becomes void. You MUST schedule an appointment to follow-up with your physician 60 DAYS FOLLOWING THE DATE OF YOUR FIRST PT VISIT. If your therapy is to continue for a prolonged period of time, you must maintain scheduled appointments with your physician every 30 DAYS after the first 60 day follow-up visit. These are requirements of Medicare, established to ensure you are receiving skilled and justified treatment. They also have the option of denying payment for your services at any time they it is excessive and/or unwarranted.

How much do I have to pay for PT services?	Each PT clinic has its own individual price scale, so contact your clinic of choice and ask for a copy. Be aware that MANY insurance companies (Medicare, Blue Cross / Blue Shield, Workman’s Compensation, to name just a few) have their own list of “allowable charges” that may be lower than the price listed for the services provided by the PT clinic. In this case, the PT clinic cannot receive reimbursement, from neither the insurance company nor the patient, in excess of the allowable charges.

What do the different initials stand for after my therapist’s name (i.e. PT vs MPT vs DPT)?	These initials designate the types of degrees available in Physical Therapy: PT: Indicates the therapist has received a Bachelor of Science degree in PT. This required usually 3 years of prerequisite college classes followed by 2 years and 2 summers of classes and clinicals prior to receiving their degree. Most universities in the US have not offered a Bachelor’s degree in PT since the year 2000. MPT: Master’s Degree in PT. Indicates the therapist has received a 4 year Bachelor of Science degree (this degree does not have to be in any way related to PT, although there are certain prerequisite classes required prior to entering PT school) and have taken 2 years and 2 summers of classes and clinicals in a PT program addition to this. DPT: Doctorate Degree in PT. Similar to the time frame for the MPT but usually two additional semesters in a PT program related to research and administration, and may include some additional clinical time. The current trend is for all PT programs to be transitioned into DPT programs.