Do You Need a Referral for Physical Therapy?

Whether or not you need a referral for physical therapy can vary depending on your location, your health insurance, and the specific circumstances of your condition. Here are some general guidelines.

• Direct Access: All U.S. states have some form of direct access to physical therapy -- that is, you can see a physical therapist without a referral from a physician. However, the limitations on direct access can vary based on where you live. There could be limits on the number of visits or the types of treatments you can receive without a referral, so it's essential to check the specific regulations in your state.
  • For more info on direct access in Illinois, click here.
• Health insurance: Your health insurance plan may require a referral for physical therapy. If you plan to use your insurance to cover the cost of therapy, you should contact your insurance provider to understand their requirements.
• Medicare: If you have Medicare, you do not need a referral for physical therapy. However, after your initial evaluation, your therapist will send your plan of care to your physician to sign so that you can continue to receive treatment.
• Post-Surgery: Some post-surgical cases may require a specific aftercare protocol based on your surgery. In this case, a referral from your surgeon is required.

It's essential to check with your insurance company and/or the specific physical therapy clinic you plan to visit to determine whether a referral is necessary in your situation. They can provide you with the most accurate and up-to-date information regarding your specific needs and circumstances.