For those patients wishing to see our clinical staff, there are two ways in which you may access our services:
1.) Referral by Physician, Physician Assistant, Nurse Practitioner, Surgeon, or other Healthcare Provider (see list below)
2.) Self Referral (Direct Access)
This term references the ability of a public person being able to see a Physical Therapist (PT) without physician referral. As of 1/1/2015, all 50 states of the U.S.A. including Washington D.C. have “direct access” to seeing a PT, including the state of Oregon, which passed legislation in 1993. This means that any patient has the legal right to seek out services from any PT that they wish to see.
At present, approximately 50-60% of insurance plans will cover physical therapy treatment without a physician referral. For those patients who wish to pursue self-referral without insurance, please contact our office staff about other payment options.
EXCEPTIONS (State of Oregon) (3)
For individuals living in Oregon, no physician referral is required for physical therapy services to see any PT if they are:
1.) a student athlete at a public or private school, college or university and is seeking treatment in that role as athlete.
2.) is a child or a student eligible for special education, as defined by state of federal law, and is being seen pursuant to the child’s or the student’s individual education plan (IEP) or individual family service plan.
3.) a resident of a long term care facility as defined in ORS 442.015 (14)(b)(A)
4.) a resident of an adult foster home as defined in ORS 443.705
5.) a resident of an intermediate care facility for mental retardation pursuant to federal regulations
Patients should not confuse the term “Referral” or sometimes called a “Prescription for Physical Therapy” with an insurance term “Authorization.” These terms are completely different. A Physical Therapy Referral is given to you by your referring physician or other health care professional that meets the criteria for Physical Therapy Referral (see “Health Care Providers who may refer..” as listed below). Many insurance companies still require such a referral to give you, the patient, benefits for physical therapy. We presently encounter approximately 20-30% of insurances that do not require a physician referral. This “referral” is a slip of paper, much like a prescription for medication, that is given to the patient (or faxed to the physical therapy office), to present to the PT clinic to start rehabilitation. For many health insurance policies, this is the first step in the process. Then our office must obtain a “prior-authorization”, which simply is a verification process that your insurance validates they will pay for services rendered for your diagnosis. For many insurances, this means if you start rehabilitation prior to receiving this, they may not pay for those visits until such “authorization” is granted. This often can mean a delay in you receiving care.
Physician (M.D., D.O.)
Physician Assistant (PAC)
Nurse Practitioner (NP, ANP, PNP, FNP, GNP)
Naturopathic Physician (N.D.)
Podiatrist (D.P.) (For Lower Extremity problems only)
Dentist (DDS, DMD) (For craniomandibular disorders, i.e. TMD,
HEALTH INSURANCE: Most require prior authorization, so please contact our office staff for assistance. We accept almost ALL insurance plans, recently (2008) adding Providence, Aetna, and Cigna.
SELF PAY: For cash paying patients, please contact our office for our fees.
(1) American Physical Therapy Association
(2) Oregon State Law: 688.132