Physical therapy (PT) might be covered by your insurance plan, either partly or in full. However, your insurance will need your healthcare provider to confirm that PT is medically necessary before they will pay. This applies to private and other insurance plans, including Medicare.
Physical therapy typically requires several sessions. Even if your insurance fully covers PT, the costs can still add up because of your co-pays. If you only have partial coverage, you’ll have to factor in that cost as well as the portion of the service fee that you’re responsible for paying.
Here’s what you should know about insurance coverage and out-of-pocket costs for physical therapy.
Estimating the Cost of Physical Therapy
Before you attend PT, find out what your out-of-pocket costs could be. Understanding how these therapy services are billed will help you get these numbers.
Physical therapists bill for their services based on what they do during sessions. For example, your first visit is an initial evaluation and it’s usually billed at a higher rate than follow-up sessions.
During follow-up therapy sessions, your therapist may bill for the various treatments performed.
For example, if your therapist does an ultrasound, performs joint mobilizations, and prescribes exercise during your session, then three separate units of therapy will be billed. Each one will have a different charge, and adding up these charges will give you the total cost billed.
Cost With Insurance
If you have health insurance, contact your provider and ask about coverage for PT before making your first appointment.
When you talk to your physical therapist, ask if they are a participating provider with your health insurance company. Staying in-network can keep your costs down. If the therapist you want to work with is in-network, provide them with your insurance information. From there, the therapy office will submit claims for payment to your insurance company.
If you have Medicare as your primary insurance, your plan will cover about 80% of the claim for PT, and you may have to pay the remaining 20%. Many people have secondary insurance that will cover all or a portion of the remaining bill.
What Is Insurance Cost-Sharing?
Many people have insurance plans that include cost-sharing. In this arrangement, some of the costs of services are covered by your insurance carrier and some out-of-pocket costs are your responsibility.
You may also have a co-payment to pay each time you visit your therapist. You may also have a deductible to meet each year before your insurance coverage will start paying for PT.
Most people have a co-payment of about $25 to $35 per therapy session. However, some co-payments can be as high as $50 or $75.
Talk to your insurance company before you start PT. They can help you determine how much you will likely end up paying for each PT session.
Cost Without Insurance
If you do not have health insurance, you will have to pay for your PT yourself. When you contact your therapist’s office, them that you do not have insurance and that you wish to pay for services out of pocket.
Co-Payments Can Add Up
PT is often ongoing and not just one appointment. You may need to go several times each week for weeks or months, depending on your recovery. Even if your co-payment for a session is small, the costs can add up over time.
Your therapist’s office can provide you with a fee schedule that lists the amount charged for each separate service that will be provided by your therapist.
Once you have a copy of the fee schedule, talk to your therapist to make sure you understand which services will be offered and billed. Then, you can decide if the treatment plan is within your means financially.
For example, if your therapist is planning to perform electrical stimulation, therapeutic activity, and therapeutic exercise during your treatment, add up what each service costs to get an idea of how much the entire session will cost.
Factors That Affect PT Cost
There are a few factors that can affect how much PT will cost. Keeping these points in mind when you’re estimating how much you may have to pay to have PT will help you prepare.
How Do Sliding Scale Payments Work?
If you do not have health insurance, the cost of PT will be around $125 to $150 per session. Your PT office will work with you to provide the best care at the lowest cost.
Surgery or Injury Recovery
If you have had a sports injury like a sprain or strain, you may only need a few sessions of physical therapy. Many people go to PT after a minor injury to learn what to do—and what not to do—while they’re healing.
Your therapist can teach you self-care exercises to do while you’re recovering. In that case, your total cost of physical therapy could be less than $100 if you have insurance or $250 to $350 if uninsured.
If you have had major surgery like a joint replacement or fracture repair, you may need to attend physical therapy for several months. In that case, your out-of-pocket expenses could really add up.
If your surgery is elective and planned, try to budget for it. For example, having some extra cash on hand to cover several co-payments a week for a few months will be helpful.
Equipment
Your therapist may recommend items you can buy to help with your recovery. You will probably have to pay for these items yourself. Examples of equipment you might need to buy for PT include:
- Lumbar roll
- Cervical roll
- Exercise ball
- Balance board
- Kinesiology tape
- Shoulder pulleys
- Resistance bands
- Assistive devices like a cane or crutches (especially if you’ll be progressing with gait training after surgery)
Your health insurance plan may not cover equipment for PT. If your PT recommends you purchase any of these items, ask them to recommend affordable options.
Keep in mind that you don’t necessarily need to buy top-of-the-line equipment. You might even be able to make some items yourself at home—for example, a lumbar roll or shoulder pulley.
Finding Affordable Physical Therapy
One of the main ways to save money on PT is by seeing a therapist who is in-network for your insurance (because seeing a provider that’s out of network will cost you more). You can call your insurance carrier to ask if a PT is in-network or search for providers online.
If you’re worried about how you will pay for PT, tell your therapist right up front. You can talk to them about how to get the care you need while keeping costs low.
The skills and motivation offered by a licensed physical therapist are essential to your recovery, but your therapist can also show you what you can do on your own. Not only will this empower you to be actively involved in your recovery, but it could also help you save money.
For example, you might be able to make PT more affordable by:
- Support a speedy recovery by following your home exercise program
- Doing therapy on your own at home and visiting the therapy clinic a few times a month for “booster sessions” (rather than several times a week)
- Ask about telehealth options (ask about insurance coverage and out-of-pocket costs compared to in-person appointments)
You might be able to reduce your physical therapy costs in other ways, such as:
- Using a health savings account (HSA) or flexible savings account (FSA)
- Ask your PT clinic or provider if they offer lower prices for services if you pay in cash (sometimes called “self-pay”)
- Reach out to patient advocates, financial assistance departments, and community resources and ask about payment arrangements or other kinds of help paying for your medical bills
- Getting an explanation of benefits (EOB) and itemized list of charges for all your medical bills to make sure there are no errors
Summary
The cost of physical therapy (PT) can vary based on the type of treatment, how long you need to attend PT, and whether or not you have insurance.
If you have insurance, contact your health insurance provider and ask about coverage for PT before you call to make an appointment with a PT. Even if your insurance will cover PT, you will most likely need to have money for the co-pay costs for sessions.
If you do not have health insurance, or if your insurance does not cover PT services, you will have to pay for it yourself. It is worth discussing ways to save money on PT with a therapist, such as payment plans or doing exercises at home.
A Word From Verywell
Working with a physical therapist can make all the difference if you’re recovering from an injury or surgery. Unfortunately, the cost of therapy services can be steep and may prevent people from realizing the gains they could make by going to PT.
If cost is a barrier to treatment for you, reach out to your provider or a local PT office and ask how you can get the best care that you can afford.
Frequently Asked Questions
- Which insurers cover physical therapy?
- Most health insurers, including Medicare and Medicaid, will cover all or part of the cost of physical therapy services. Private health insurers will often cover a portion of the cost for PT as well.You may have cost-sharing for PT, like meeting your insurance deductible or copays. Contact your insurance carrier to see if PT is a covered service.
- What is the out-of-pocket cost of physical therapy?
- If you have health insurance, you can expect to pay anywhere from $15 to $50 per session as a copay. If you are uninsured, you could pay between $100 to $250 per session.
- Is there a co-pay for physical therapy?
- Most insurance companies cover a portion of the physical therapy bill and leave the rest for you to cover with a copay. This payment will need to be made for every PT session you attend. Ask your insurance company about your financial responsibility for PT before you make your first appointment.
Most health insurers, including Medicare and Medicaid, will cover all or part of the cost of physical therapy services. Private health insurers will often cover a portion of the cost for PT as well.
If you have health insurance, you can expect to pay anywhere from $15 to $50 per session as a copay. If you are uninsured, you could pay between $100 to $250 per session.
Most insurance companies cover a portion of the physical therapy bill and leave the rest for you to cover with a copay. This payment will need to be made for every PT session you attend. Ask your insurance company about your financial responsibility for PT before you make your first appointment.
