Is Physical Therapy Covered by Insurance?
Will My Insurance Cover Physical Therapy?
It’s a good question—and one that doesn’t always have a simple answer. Insurance plans can vary a lot, and understanding what’s covered can be confusing. That’s why we’re here to guide you through the process from the very beginning, so there are no surprises when it comes to your care or your bill.
Most insurance plans do include some coverage for physical therapy. However, the details—like whether you need a referral, how much of your deductible you've met, or whether pre-authorization is required—can all affect what you’ll pay out of pocket. Some plans also limit the number of visits you can have each year.
At AR Physical Therapy, once you complete our online intake paperwork, we take care of the rest. We’ll verify your benefits, check on your deductible, find out about visit limits, and confirm any required referrals or approvals before your first appointment. Our goal is to make it easy to start care—and even easier to understand what’s covered.
Direct Access in New York State
Direct Access in New York State
Here’s something a lot of patients don’t realize:
New York State allows Direct Access to physical therapy. That means you can come directly to us—no doctor’s appointment needed—for up to 10 visits or 30 days, whichever comes first. After that point, your insurance may require a referral to continue.
Many of our patients take advantage of Direct Access to get help sooner. Whether you're dealing with a new ache, trying to stay ahead of a recurring issue, or simply want guidance on movement or performance, you can schedule an appointment with us right away. We’ll help you feel better faster, without waiting on a referral.
Insurance Plans We Work With
We regularly work with private insurance, employer-sponsored plans, Medicare, and Medicaid.
- Private Insurance: We’ll check to see if a referral or pre-authorization is needed and walk you through any copays or coinsurance you’ll be responsible for.
- Medicare: A referral is required. Medicare Part B covers outpatient physical therapy services when they’re medically necessary. There is a soft cap of $2,330 per year for combined physical therapy and speech therapy services in 2025. If your care goes beyond this cap, we document your progress and medical need to ensure coverage continues without interruption. We also send regular updates to your physician so everyone stays informed.
- Medicaid: If you’re covered by New York State Medicaid, we’ll help you navigate the requirements of your specific plan, including any referral or pre-authorization needs, visit limits, and network guidelines.
Self-Pay Options
We also offer affordable self-pay rates for patients who don’t have insurance coverage or prefer not to use it. Our pricing is straightforward:
- Initial Assessment: $150
- Follow-Up Visits: $75 each
For patients needing ongoing care, we offer discounted packages:
- 8 Visits: $65 per session ($520 total)
- 12 Visits: $60 per session ($720 total)
These options give you complete access to our care—without insurance paperwork, restrictions, or waiting on approvals. It’s a popular choice for people focused on performance, prevention, or wellness who want flexibility and clarity around cost.
We Make It Simple
We know the insurance process can feel overwhelming. That’s why we handle the heavy lifting—from verifying benefits to requesting authorizations—so you can focus on your recovery. We also make scheduling easy with online appointment requests, so you can find times that work best for your routine.
Whether you're using insurance or paying out of pocket, getting the care you need shouldn't be complicated. Thanks to Direct Access, you can begin physical therapy today—no referral required (unless you’re on Medicare or Medicaid). We’ll help you every step of the way, from scheduling to billing to achieving your goals.
Call us: (315) 932-5210
Email: contact@ar-physicaltherapy.com
Schedule online anytime.
Let’s get you moving—with care that’s simple, accessible, and centered on you.