Frequently Asked Questions

Can I use a referral from a provider who isn’t licensed in New York?

In general, no. Physicians, dentists, podiatrists and nurse practitioners who are not licensed in New York may not practice here, so they cannot write prescriptions or referrals for physical therapy performed in New York by a New York-licensed physical therapist.

There is one exemption: a physician who is licensed in a bordering state and lives near the New York border. This is generally interpreted as living within 25 miles of the border. A physical therapist may accept a referral from such a physician. The exemption applies only to physicians, not to other providers.

What is the difference between a referral, a prescription and an authorization?

Many insurance plans, in or out of network, require a prescription in order to reimburse you for treatment, even though New York allows direct access. Check with your plan before you begin.

Do you take my insurance?

We are not in-network with any commercial insurance plan. You pay at each visit: $300 for an initial evaluation and $150 (30 min) or $225 (45 min) for follow-up visits. We give you a superbill (an itemized receipt with the codes your insurer needs) you can submit to your plan for out-of-network reimbursement. HSA and FSA cards work too.

For Medicare, we are a non-participating provider and submit your claims directly to Medicare. You, or your secondary insurance, cover the 20% Medicare doesn’t pay, along with any deductible.

We do this on purpose. It lets every visit be one-on-one with the same physical therapist (no aides, no hand-offs), and lets your care follow what you need, not a visit limit.

If you plan to submit bills to your insurance, ask your insurer at the start. Because we are not in any network, finding out what your plan requires, including whether it needs an authorization (advance approval), is up to you. Here are the questions to ask. Full cost and insurance details.

Do you take Medicare Advantage?

No, we do not accept Medicare Advantage plans. We are a non-participating provider with Original Medicare and submit your claims directly to Medicare. More on cost and insurance.

Can I keep using my insurance at another clinic and also see you?

Yes, and many patients do. You can keep using your insurance benefits at an in-network clinic and add visits with us for the one-on-one, hands-on care you want more of. You may not need to see us as often, and with your permission we communicate with your other practitioners so your care stays consistent. This often works very well. We can’t know whether your insurer will reimburse our visits while you are also seeing an in-network provider, so if you plan to submit a superbill, ask your insurer first. More on cost and insurance.

I’m an existing patient with a new diagnosis. How do I schedule an appointment?

Upload your current prescription and comment that this is a new diagnosis. You don’t need to send your demographic information again unless something has changed. We will contact you to schedule a new one-hour evaluation.

I have a new insurance ID. How do I send it to you?

You can either upload a photo of your new ID card or fill out our Insurance Information form.

Can I see a physical therapist without a doctor’s referral?

Yes, for a limited time. In New York, a physical therapist with at least three years of full-time clinical experience (or the equivalent) can evaluate and treat you without a referral.

Medicare patients need a prescription (referral) at our practice. If you plan to submit a superbill to your insurance, we recommend one. A valid prescription is dated within the last 1 to 2 months and lists your name, your diagnosis, how often to treat (frequency) and for how long (duration). You can upload it or have your doctor fax it to (855) 486-2314.

Before treatment begins, New York requires your physical therapist to give you a written notice explaining that your health plan may not cover treatment without a referral. Many insurance plans will not reimburse treatment without one, so it is wise to check with your insurance carrier before you begin.

Read the state’s direct access FAQs (NYS Office of the Professions) →