Frequently Asked Questions
1. Does Insurance Cover Physical Therapy (PT)?
Yes. Insurance companies have found Physical Therapy (PT) to be a very beneficial and cost effective first line of treatment for musculoskeletal issues. Insurance companies are able to save money through conservative physical therapy treatments that have been shown to markedly reduce the likelihood of them having to pay for expensive surgeries otherwise. Most insurances and medical practice guidelines require physical therapy first before considering more invasive options such as surgery, It is rare that a service is not covered by insurance. If so, your therapist would disclose this prior to administering treatment for your approval.
2. Do I need a doctor's referral to go to Physical Therapy and be treated by a Physical Therapist?
North Dakota (ND) is a direct access state. This means that insurances are allowed to cover PT services without a doctor's referral if they so choose. Most commercial insurance companies in North Dakota do not require a referral from your physician with the exclusion of Medicare and Medicaid programs which do require a referral. Again each plan is different so calling the insurance is the easiest way to find out. We can do this for you if you would like. Both the Insurance and the patient are saving money this way because they don't have to pay for an additional Dr's visit just to be referred on to PT. A Doctor of Physical Therapy will perform a complete physical assessment as part of the initial examination on your first visit to screen for any other medical conditions that would require additional medial attention.
3. Does insurance cover Dry Needling?
Dry needling has become a very popular new treatment in the medical field for treating various muscle injuries. Unfortunately, it is not recognized as a proven treatment by most insurances and therefore is not covered as a physical therapy treatment. As an active patient, we still incorporate it into your treatment. If you are seeking only dry needling, then we also have cash options for those services.
4. How much will I pay out of pocket for each PT treatment session?
This will vary depending on each individual's insurance. In most cases it is the same as an office visit to the doctor. Traditional plans have a "copay" that is due at the time of service and also may have a "co-insurance" that is a percentage of the remaining cost after claims are run through insurances. Those with a high deductible health plan (HDHP), the cost is paid by the patient until your deductible and/or out of pocket max is met and then insurances cover the rest. Again we can call your insurance for you and let you know what your individual cost will be with your plan.