Insurance and Billing for Physical Therapy Treatment
At Passages Physical Therapy, we are happy to provide billing through your insurance. We participate in Medicare and are an in-network PPO provider participating with Anthem BlueCross BlueShield, Coventry, Optima, Sentera and Southern Health. We accept Tricare allowables; preauthorization is required as out-of-network for Tricare HMO. We also provide billing as out-of-network PPO providers for Aetna, Anthem Healthkeepers with PPO option, Cigna, United, and other insurances with PPO coverage. Some credit and medical spending account cards are accepted.
Physical therapy in Virginia is usually prescribed through an MD, DO, NP/CNM. An initial visit and short term PT is now sometimes possible before seeing your primary provider through special direct access certification, in specific situations. Your insurance may require the medical PT prescription for your coverage. Wellness education does not require prescription, and is not covered by insurance.
We can help you to find out about your physical therapy benefits, and will assist with certain pre-authorizations for treatment when required. We prefer to talk with you about the type of symptoms you have, to help learn about coverage. We are happy to make the contact for you to find out about your general PT benefits. Please note that our assistance is advisory, and we cannot guarantee coverage.
The initial evaluation is the best way to determine if PT is appropriate for you, and what is likely to be covered. Our treating diagnosis normally describes the problem behind your symptoms: muscle spasm, weakness, posture, pain in the pelvis, spine, hips, etc. Our experience is that insurance traditionally covers physical therapy when it is submitted in terms describing the musculo-skeletal or soft-tissue dysfunction, instead describing the symptom itself.