Do I need a referral for physical therapy? Since January 1, 2006 you no longer need a referral for physical therapy or sport physical therapy. Of course, you can always make an appointment with your doctor first, but it is no longer required.
Exceptions exist when your symptoms are on the Chronic List, in which case the costs fall under basic insurance, beginning with the 21st treatment. In this case a referral from a specialist is required.

Going to the (sport) physical therapist without a referral has certain advantages. It means that you can go directly to the specialist and immediately begin working toward recovery. This is also called “direct access” or “self-referral”. The doctor still plays the main role in coordinating your health care. The physical therapist will keep your doctor informed unless you prefer and state otherwise. If you decide to go straight to your (sport) physical therapist, then you will first have a screening. During the screening, the physical therapist will assess your situation and help you decide if you are in the right place. If not, then you will be sent to your doctor or sport doctor.

The insurance company considers the screening a full treatment. So, if you are at your doctor ask for a referral. This will save you a treatment. If you can be treated by the (sport) physical therapist, then (with your input) a treatment plan will be designed for you. This is great because the faster you can be treated, the faster you can get on the road to recovery.


Translate by Kate Gentile