6 Physical Therapy Contract Gotchas
- Visit Limit Caps: HIGH Insurance may cap PT visits at 20-30 per year. Authorization required for additional visits
- Copay Per Visit Adds Up: HIGH $30-75 copays per visit compound quickly. 2-3 visits/week can cost $300-900/month out of pocket
- Prior Authorization Delays: MEDIUM Some insurers require prior auth that takes days. Treatment may be delayed or denied
- PTA vs. PT Treatment: MEDIUM Sessions may be led by Physical Therapist Assistants, not the licensed PT who evaluated you
- Discharge Policy: MEDIUM Clinic may discharge you for missed appointments or non-compliance with home exercises
- Equipment and Supplies: MEDIUM Therapeutic items (braces, bands, foam rollers) often billed separately at markup