“Do I need a referral for physical therapy?” This is one of the first questions we hear when a person is interested in starting physical therapy. The simple answer is no, you don’t. Colorado is a direct access state which means that you can see a physical therapist for evaluation and treatment without a referral from a physician.
Colorado became a direct access state in 1988. Eighteen other states have this same unrestricted patient access, while twenty six others have “patient access with provisions” meaning that people may seek evaluation and treatment with some restrictions on the duration of care or the number of visits. Other states may have a referral requirement for specific interventions such as needle EMG or spinal manipulation and only six states have “limited patient access” meaning that physical therapist services are only accessible to certain patient populations or under certain circumstances.1
So in most states, including Colorado you are able to see a physical therapist without a referral. However, the more important question is whether your insurance will pay for it or not. Some insurance contracts may require that a patient obtain a referral from a physician in order for the appointment to be covered. In Colorado most insurance plans do not require a referral but it is still recommended that you contact your insurance provider for confirmation.
So why does direct access matter? According to the American Physical Therapy Association, the benefits of direct access include: saving time and money that might be spent obtaining a referral, improving access to care, making physical therapists responsible for therapy decision making, and offering services in areas such as prevention, fitness, and health promotion.2 Physical therapists are doctors who specialize in preventing and rehabilitating neuromuscular and musculoskeletal pain and dysfunction. Our goal is to get you feeling better as soon as possible and this is easier to accomplish when therapy is initiated immediately. When you are injured, waiting for an appointment with a physician can lead to significant amounts of pain and suffering. Instead of waiting, a physical therapist can provide a thorough examination and begin helping you feel better immediately with individualized exercise, modalities and hands-on treatment. Your therapist will also provide referrals to other health care providers if additional care is required.
Physical therapy is an important tool to help you feel your best and maintain the lifestyle that you enjoy. At Integral Physical Therapy, we encourage you to use your right to directly access physical therapist services that are proven to lessen your pain and improve your function. Please give us a call and we would be happy to check your benefits and inform you if your insurance plan requires a referral before your first appointment.
1. American Physical Therapy Association. A Summary of Direct Access Language in State Physical Therapy Practice Acts.
2. American Physical Therapy Association. Direct Access: How It Can Change Your Practice.