In order to facilitate the initial consultation, please print out and complete both the Intake and Consent forms to the right and bring them to your first session.
In New Jersey, patients are able to be evaluated and treated by a licensed physical therapist without a physician’s referral, called Direct Access. Some insurance plans may still require you to consult with a physician first, in order to be reimbursed for services, so please check with your insurance provider as plans differ.
Direct access benefits patients in that it allows patients to expedite treatment, saving time and money.
New Jersey Direct Access Provisions
The physical therapist shall refer patient to a health care professional licensed in New Jersey for the following reasons:
- If the PT has reason to believe that services outside of physical therapy are needed
- Patient has failed to show reasonable progress within 30 days of initial treatment
At 30 days from initial evaluation, the PT shall inform the patient’s licensed health care provider regarding the patient’s plan of care.
How does On The Spot Therapy handle Direct Access?
- Prior to your first appointment, please check with your insurance provider about reimbursement policies.
- At your initial evaluation, in accordance with State regulations, you will sign the written consent form.
- At any time during evaluation and treatment, if your condition is more involved or not progressing, you will be referred to an appropriate specialist.
- After 10 visits or 30 days, if further visits are needed, you will need to contact a physician for a Physical Therapy Prescription.
What does this mean to me?
By law, you are no longer required to obtain a physician’s referral prior to being treated by a PT. This means that you can be evaluated and treated by a licensed physical therapist immediately, which results in better outcomes and reduced costs.
Why it makes sense for you to go Out of Network
- Book an appointment that works at a time convenient for you- not the clinic.
- Do you know what your co-pay is? Having to pay $30 2-3x/week for an in network clinic is no less than having one visit a week in an out of network setting. You only need one because you will get so much more accomplished in a private session.
- If you have already met your deductible and have out of network benefits for physical therapy, then it's definitely a no brainer!
- You can use you HSA or FSA card to pay.
- It's just better care.
On the Spot Therapy LLC is an Out of Network, Fee for Service provider of Physical Therapy services. The patient is responsible for filing all insurance claims. We will provide you with an INVOICE if you would like to submit receipts to your insurance provider for reimbursement. The cost of one hour of highly individualized treatment and instruction is $100. First time Initial Evaluations are $180. Payments can be made via cash, credit card or check, made out to On The Spot Therapy LLC. HSA and FSA cards can be used to pay for therapy services. Most insurance providers with out of network benefits will cover the majority of treatment costs!
To clarify your insurance benefits, I recommend calling the member services number on your card to find out:
- If you have Out of Network benefits (OON) and what percentage of cost is reimbursed?
- Have you met your OON deductible?
- Do you need pre-authorization for physical therapy and how many visits are you allowed per year? (I can call and get authorization if needed)