Do I Need a Referral for Physical Therapy?

Do I Need a Referral for Physical Therapy?

Direct Access to Physical Therapy

Direct access to physical therapy services in Georgia offers you the freedom to take control of your healthcare journey. At Back In The Game Physical Therapy, we empower you to seek evaluation and treatment from our experienced physical therapists without the need for a referral from your primary care provider.

What is Direct Access?

Direct access laws in Georgia allow you to initiate physical therapy treatment without a referral from a primary care provider, subject to certain conditions. This means that when you need help with a sports injury, auto accident injury, or simply want rehab to help you play your best round of golf yet, you can reach out to our team directly for a physical therapy consultation.

Let’s take a look at exactly what direct access means, and what you need to know in order to make your first appointment.

Benefits of Direct Access

Direct access laws allow you to stay in the driver’s seat of your healthcare. Being able to make your first appointment with your physical therapist without having to first get a referral from your primary care provider means that you save time and money while getting the care that you need.

In order to utilize direct access care from a physical therapist in Georgia, you’ll need to make sure that you stay within a few parameters, including:

  • You can receive an evaluation and up to 8 visits or 21 days of treatment, whichever comes first, under Georgia law, provided your insurance allows it. 
    • Patients with Medicare, Tricare, or VA insurances still require a script from a medical physician before treatment can begin.
    • Some commercial insurances may also require a physician’s script, though this is rare.
  • After the initial evaluation and treatment period, a physical therapist can see you once per condition every 60 days.
  • Physical therapists must wait 2 years after graduation to practice, unless they gain a post-graduate certification.
  • You have not been seen by another physical therapist in the past 90 days
  • You’re seeking physical therapy to prevent injury, work on conditioning, boost your fitness, or reduce your stress levels.
  • You show improvement within 90 days of your first physical therapy appointment.

At Back In The Game Physical Therapy, our team is here to help you feel your best. If you have questions about direct access care, don’t hesitate to reach out to us to learn more.

The Purpose of Referrals

Referrals to physical therapy providers and other specialists from a primary care provider allow your physician to understand the next steps in your care. Referrals can also create an easier intake process, as your physical therapist will already have your medical history and other background information necessary for your treatment.

If you have a referral, we will work with your primary care provider to ensure your treatment plan is personalized to your needs. If you do not have a referral, no worries. We’ll talk with you to gather the information necessary to develop your personalized treatment plan.

When You May Need a Referral

Insurance coverage for physical therapy can be complex. If your insurance plan covers physical therapy benefits, your visits may be covered. You may need to pay out-of-pocket if you have a deductible on your health insurance plan.

Moreover, depending on your insurance plan, you may need to get a referral from a physician after 30 days have passed since your first physical therapy appointment. If you’re unsure about whether you need to get a referral from your care provider, don’t hesitate to ask.

What About Insurance?

Insurance can be complicated, and we’re here to help. If your insurance plan offers physical therapy benefits, your visits to Back In The Game may be covered by your plan. If you have a deductible on your health insurance plan, you may need to pay out of pocket before your insurance will pay for your physical therapy appointments.

We’re here to help you get the care that you need. Reach out to the Back In The Game Physical Therapy team today to get started.

About the Author

Andrew Kneeburg

PT, DPT, Clinic Director

Specialties: Shoulder injuries and post operative surgical rehab

Certifications: Dry needling and spinal manipulation

Location(s): Dacula, GA

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