HOW TO CHOOSE A Physical Therapist

One of the most important decisions in your recovery after experiencing pain or an injury is choosing the right physical therapist (PT) to guide you back to health.

Freedom of Choice

You have the freedom to choose your own physical therapist. Maine allows direct access to physical therapist services without a physician’s referral. Keep in mind, however, that your insurance policy may require a physician referral as a condition of payment. Your physician may refer you for physical therapy that is to be provided in the physician’s office, a facility in which the physician has a financial interest, a hospital or a privately owned physical therapy practice. Be aware that you have the right to choose your own physical therapist and that you are not obligated to receive
physical therapy in any specific facility.

How to Choose a Physical Therapist

Make sure that you receive physical therapy from a licensed physical therapist. If you are receiving physical therapist services from a physical therapist assistant, be sure that he or she is also licensed and that the care is being directed and supervised by a licensed physical therapist. Physical therapists specialize in a wide variety of areas (such as orthopaedics, pediatrics, sports and work-related injuries, chronic pain, geriatrics, neurology and womens’ health), so you will want to choose a PT who has expertise in treating your specific medical problem.

Specialization

Highly trained expert PTs are frequently residency or fellowship trained, are “Board Certified” in specialty areas of practice, or have additional certifications in a particular treatment approach, such as manual therapy and manipulation. Ask about what training the PT has beyond their entry-level PT education. You can search for a PT by their specialty in your zip code by going to the American Physical Therapy Association’s
website at www.apta.org and clicking on “Find a PT”.  Convenient Hours and Priority Scheduling Research shows that early PT intervention after an injury results in less visits being required and a better outcome, so if you have to wait more than a couple of days for an appointment or be put on a “waiting list,” consider going somewhere else. Many PT clinics also offer convenient before and after work hours, which might also be
important to you.

Quality Care

Your therapist should explain his or her treatment plan and give you an idea about how fast to expect results. One good indicator of quality care is whether your physical therapist spends one-on-one time with you performing “hands-on” treatment. If you don’t get better in a reasonable time frame or you are seen by a different person or unlicensed support staff each time you have PT, you might not be getting quality care. Talk to your PT about your concerns and/or consider going somewhere else. A good PT will respond positively to your questions and may even refer you to another
practitioner who can help you more.

How much will the PT services cost?

The cost of your services largely depends on whether you go to a hospital-based PT clinic or a private practice and whether your PT is “in-network” or “out of network” as well as what services you receive. Generally speaking, PT services cost significantly more (30-200% more!) at hospital-owned facilities than at private practices. So if you have a high deductible or you have to pay a percentage (co-insurance) of the cost of your care out of your pocket, you should consider seeking PT from a private practice in your local area even if your physician initially refers you to the local hospital’s PT service.  To get a cost estimate, just call the physical therapy practice and ask how much a typical physical therapy visit costs. Most private practices will answer that question easily, but hospitals may not. However, you can find the average cost of physical therapy services for hospital-owned facilities and some corporate/physician-owned practices at www.comparemaine.org. Just choose the “therapeutic exercise” code (CPT Code 97110) and multiply the amount by 4 to get an estimate of the cost of a 1-hour visit.  (Most physical therapy services are billed in 15-minute increments and all codes are
similarly priced, so you don’t necessarily have to know what codes will be billed to get a close estimate.)

In vs. Out-of-Network Providers

Don’t assume that it is always cheaper to go to an in-network PT. If the in-network hospital PT charges twice as much as the out-of-network private practice PT, you may end up paying more in-network! Also, if your health plan does not have the PT specialist you need in its provider network, your health plan may authorize you to see the out-of-network PT specialist you need to see at little or no additional cost to you. Talk to your chosen PT about what your options are if he or she is out-of-network.