Direct Access

Maine became the 25th state to enact “direct access” legislation regarding physical therapy in an effort to help reduce healthcare costs. Direct access means you can go directly to a licensed physical therapy provider for evaluation and treatment without a doctor’s referral. And, you have the right to choose which physical therapy provider you go to, even if you are directed to go elsewhere.

Many conditions are successfully treated by hands-on treatment and individualized exercise programs provided by your physical therapist. Painful and expensive surgeries can be put off and sometimes even eradicated altogether. Plus, physical therapy has been known to reduce and sometimes even eliminate the need for dangerously addictive painkillers. Physical therapists are also highly trained in identifying conditions that might need further evaluation or medical treatment and can include primary care physicians when needed.

 

Direct Access to Maine Physical Therapists provides many benefits, including but not limited to:

• •  This will give you much quicker access the treatment you need and deserve.
• •  While each patient case is different, clinical research shows that Direct Access typically saves you money.
• •  Physical therapy visits last 30-60 minutes so your condition is thoroughly evaluated.
• •  In many cases, seeing a physical therapist first will result in fewer overall treatment sessions.

There are also guidelines and restrictions for direct access to physical therapy treatments in Maine.

 

Under Maine direct access laws, the Physical Therapist:

• •  Cannot make a medical diagnosis.
• •  Must not administer or prescribe pharmaceuticals.
• •  Must not apply manipulative mobilization to the vertebrae of the spine.
• •  Must refer you to an appropriate licensed healthcare provider if your condition requires treatment beyond the physical therapy provider’s scope of practice.
• •  Must refer you to an appropriate licensed healthcare provider if no improvement is noted in the patient record within 30 days of the first treatment date.
• •  Must consult with or refer you to an appropriate licensed healthcare provider if physical therapy treatment is required beyond 120 days.

In Maine, some insurances require a referral, regardless of the direct access laws.

• •  If you are an HMO insurance patient, a referral is required from your primary care provider (PCP) listed on your insurance cards.
• •  Medicare patients require a referral from an MD, DO, PA-C, NP, or DPM. The referring healthcare provider must also sign, date and send back to Medicare the initial evaluation in order for Medicare patients to receive coverage.
• •  Workers’ Compensation carriers require a referral and prior authorization from either your adjuster or nurse case manager.

Before making an appointment with us, it’s a good idea to check with your insurance carrier to verify your benefits for direct access physical therapy treatments, so there are no unpleasant surprises.