What is Direct Access and Why You Should Take Advantage

What is Direct Access and Why You Should Take Advantage

Janie Schneider, PT, DPT, Cert. DN

So, you have hurt your ankle or your back. What is the next step? We hope physical therapy at Center for Physical Therapy and Sports Medicine will be your first call!

One of the most common myths surrounding physical therapy is that you need a prescription. This is not true! For most insurances, you can see your physical therapist in Virginia for up to 60 consecutive days without a prescription! This is HUGE for getting your pain under control and saving your money and your time.

If you chose to see a physical therapist, we will get you scheduled as soon as possible, usually within just a few days! The physical therapist is trained to perform a thorough screen to rule out any red flags or any potential diagnoses that we cannot treat. After the evaluation if we determine that we can help your pain, you are one step closer to getting relief!

How much can you actually save? 

A recent study in Journal of Orthopaedic and Sports Physical Therapy found that patients that went to physical therapy first saved on average $1,543 than those who went to a physician first. Along with these savings, they found that the patients who went to PT first actually had fewer visits and had similar improvements as compared to physician referred patients. In a study in 2012, patients that went to PT early after an acute episode of low back pain were less likely to need injections, surgery or more physician follow up appointments3. This is all leads to less money and more time for yourself! Who wouldn’t want to get better faster and save money if you get the same results!



Is it safe to go to a PT first without going to my primary doctor or other physician?

Yes! Physical therapists are now required to have a Doctorate or take other training to become Direct Access certified. Physical therapists are trained in screening for sinister diagnoses including cancers and we are trained in referring out to the appropriate provider on a timely basis.

Will my insurance cover physical therapy under Direct Access?

Yes! Most insurances reimburse the same amount whether you have a prescription referral or not! A lot of insurances require you to go to physical therapy for a set amount of time before they will even pay for a MRI or other advanced imaging. Medicare and Worker’s Compensation are exceptions to this rule. If you have a question about your insurance, call us or call your provider.

If I don’t have a MRI how do you know what is wrong with me?

We get this question a lot! There are tons of research articles out there that demonstrate the validity, reliability and other statistics that show that some of our special tests are quite good at ruling in an injury or ruling out an injury. When comparing our clinical diagnosis to a MRI diagnosis (gold standard), physical therapists show a 75% agreement rate and non-ortho physicians show just a 35% agreement rate2. The difference between physical therapists and orthopaedic surgeons is not statistically significant.

To Summarize

Direct Access gives you the ability to come right to physical therapy without a prescription referral for up to 60 consecutive days. Direct Access will save you money by avoiding unnecessary office visits and images. It will save you time by getting in to see a PT within 2-3 days of your injury and quicker recovery. If we can’t help you resolve the issue completely, we are knowledgeable in who to refer you to for a quick streamlined approach.

Call us at Center for Physical Therapy and Sports Medicine today!

1. Denninger TR, Cook CE, Chapman CG, Mchenry T, Thigpen CA. The Influence of Patient Choice of First Provider on Costs and Outcomes: Analysis From a Physical Therapy Patient Registry. J Orthop Sports Phys Ther. 2017;:1-26.

2. Moore JH, Goss DL, Baxter RE, et al. Clinical diagnostic accuracy and magnetic resonance imaging of patients referred by physical therapists, orthopaedic surgeons, and nonorthopaedic providers. J Orthop Sports Phys Ther. 2005;35(2):67-71.

3. Gellhorn AC, Chan L, Martin B, Friedly J. Management patterns in acute low back pain: the role of physical therapy. Spine. 2012;37(9):775-82.

4. Image 1: https://larphysicaltherapy.com/2017/06/11/direct-access-for-early-treatment/

5. Image 2: https://www.google.com/search?q=get+pt+first&rlz=1C1CHBF_enUS721US721&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj9oay4xtrZAhWMuVkKHQDOCF4Q_AUICigB&biw=1366&bih=637#imgrc=oCtVWdUSzg_vbM: