Is Pelvic Floor Physical Therapy Covered by Insurance?
When you are looking for pelvic floor physical therapy, one of the questions you may be curious about is whether or not your insurance covers it.
Many insurance companies offer coverage for pelvic floor therapy (PFPT), particularly when it is deemed medically necessary.
Major insurers can commonly cover PFPT however, the specifics of coverage can vary based on your insurance plan and state regulations.
For instance, Medicaid coverage differs from state to state. Some insurers may also require a referral from a physician or pre-authorization from a medical provider.
Even if your policy includes coverage for pelvic floor physical therapy, it's important to note that not all physical therapists may be covered under your plan, just like with doctors and other specialists.
Additionally, some pelvic floor physical therapists operate in out-of-network clinics that do not accept insurance, although they might offer invoices for those seeking reimbursement from their insurance carrier.
Out-of-network means the clinic does not directly submit paperwork to insurance companies.
This allows practitioners to work more freely and allows the therapists to tailor their approach to each patient's specific needs and goals. This personalized attention can strengthen the relationship between the therapist and the patient, potentially accelerating the healing process.
An out-of-network PFPT can create personalized treatment plans customized to each patient’s needs without being limited by insurance restrictions.
They might also offer a wider range of therapeutic modalities that may not be available in insurance-based practices such as dry needling techniques.
Lastly, out-of-network clinics have transparent pricing upfront.
This can simplify the process by avoiding the complexities and inconsistencies often associated with insurance billing, where charges can fluctuate from visit to visit and bills can come months after your treatment is over.
So, yes. While pelvic floor physical therapy CAN be covered by insurance, oftentimes you will receive better care, more personalized attention, and will likely have symptom improvement faster than if you tried to utilize your insurance. Plus, you know the cost up front, which is a very positive thing in our healthcare system.
If you are looking for a pelvic health physical therapist in the Jacksonville Beach area, we offer pelvic floor treatment at Samson Strength and Performance Physical Therapy and would love to work with you.
Get started by booking a discovery call with one of our pelvic PTs. We’ll answer your insurance/private pay questions as well as address any concerns you have about pelvic physical therapy.
