As 2014 settles in, it is important for me to share something VERY exciting to me AND
important to YOU! A long time in the making, but the ability for you to seek treatment from
a licensed physical therapist is NOW possible WITHOUT seeing your physician first!!! This
is called ‘direct access’ meaning that the consumer can choose for him or herself a course
of action within the medical arena that does NOT have to start with the physician or other
referring provider. AB1000 was signed in October 2013 that made this possible. After numerous
political battles with the various groups in California, we now can enjoy the professional
freedom to practice as many others do in 36 other states in our union. WHEW!
THIS IS HUGE for those of you who might either know my work and would like to return for
a different issue or want to seek services based on a word-of mouth referral. Now there is
one catch (always is)…and that is that this ‘freedom’ to treat any particular problem has to be
completed in 12 visits OR 45 days whichever occurs first. IF the treatment needs to be extended
past that ‘rule’ a physician must evaluate this new problem and direct care as appropriate
from that time on. Make sense??? Most of us although extremely skilled and pragmatic are not
licensed to diagnose disease and order tests that may be indicated and would find ourselves
seeking this level of intervention even if it were not mandated.
Now for payment you ask. Yes, the next barrier but MEDICARE and United Health Care are
currently on board with the new ruling. This means they will pay for such services as long as we
have the other paperwork in line (for the MEDICARE folks). This includes what is called a plan
of care which MUST be signed off within 30 days of starting care by your physician. This way
everyone is on the same page and notified. Now although this is a time and money saver, there
are times that seeing the doc FIRST is needed and an educated PT will certainly turn you away
to do so IF there are ‘red flags’ that warrant more in depth investigation.
As a result the staff are trained to now ask you WHAT you are seeing PT for and IF I see
something that is a concern I will contact you BEFORE the initial appointment (rare) if I think
seeing me first is inappropriate. This saves us all time and frustration and puts your care as my
So, if you have questions about this or anything else regarding a referral please visit my website
as updates will be added (under the NEW PATIENT tab) as they become available. You can also
call your provider to see IF they will cover the PT service and honor the new law a.k.a. “do not
require a legal referral” to begin services.
THANKS for your support as we move forward in California to provide the best service to you as