Do I need a prescription from a doctor to have physical therapy?
No, you do not need to have a prescription to be seen in physical therapy. Physical therapists in the state of California have Direct Access. This means that if you have a condition requiring physical therapy you can be treated for 12 visits or 45 days, which ever comes first, before you need to see your doctor. If you require PT after that time for your condition, you will need to get a prescription. If you don't have a doctor, you will be referred to one best suited to your needs.
Will my insurance pay for physical therapy if I don't have a prescription?
This depends on your insurance company's requirements. Some still require a prescription and some do not. If you are not going through your insurance company and you are paying out-of-pocket then it won't matter. *If you are using Medicare then you will need a prescription from your doctor for physical therapy.
If you are "out-of-network" with my insurance company, does this mean you won't take my insurance?
No, not necessarily. This just means your "out-of-network" benefits need to be verified to see what your coverage will be. Depending on your insurance company, your specific plan, and your deductible, going “out-of-network” may actually be a better option for you than choosing an “in-network” provider.
Why would my health care provider choose to be "out-of-network" vs. "in-network" ?
Being "out-of-network" means that a provider (PT, MD, DO, etc) has chosen not to enter into a contract with a particular insurance company. These "contracts" limit the provider in which services they can offer due to what the insurances companies will or will not pay for, even if that means not paying for a treatment/service that the provider feels you need. In some cases, being "in-network" with certain insurance companies mean reimbursements lower than cost of care. When a provider goes "out-of-network" though they do not get listed in your insurance booklet of who you can see, so they don’t get the free advertising to large group of people.