Most Insurance companies offer 30 to 120 visits for physical therapy. Medicare and Medicaid provide Physical Therapy benefits that many of my patients don’t fully understand. Both Medicare and Medicaid have what is called a Physical Therapy cap. Just like private insurance that people get as a benefit from their employer or purchase individually, Physical Therapy benefits are limited. For Medicaid the cap is 25 Physical Therapy visits per year. Medicare requires that the patient pay a $155 deductible, then they pay 80% of Physical Therapy services up to a cap of $1860. For my patients, a Medicare cap of $1860 would provide them with approximately 22 treatments per year. For my average patient and compared to many private plans, I find these limitations quite generous.
Will my insurance cover the cost of my equipment and supplies, like electrodes, braces, hot packs, Theraband, and orthotics?
Some insurance companies have “Durable Medical Equipment (DME)” coverage, however Boston Sports Medicine is a physical therapy provider, not a DME provider. Any equipment you purchase through Physical Therapy Associates must be paid for at the time of your visit. We can provide you a receipt to submit to your insurance company.