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Compare telehealth physical therapy
Your next PT visit may be virtual to keep your recovery on track.
Physical therapy relies on real-time interaction to help patients feel and move better, and telehealth is bridging the gap while social distancing guidelines are in place. But it’s a fairly new way of delivering care, so it has its limitations — and it’s not covered by all insurance policies.
What's in this guide?
- How does telehealth physical therapy work?
- What are the benefits of virtual physical therapy?
- Limitations of telehealth physical therapy
- Conditions telePT can help with
- How to set up your virtual physical therapy session
- Does insurance cover telehealth physical therapy?
- How to find a telehealth physical therapist
- What are my alternatives?
- Bottom line
How does telehealth physical therapy work?
Telehealth physical therapy (telePT) is the practice of providing physical therapy services via virtual platforms, rather than in person. It’s a form of telemedicine which relies on video conferencing to be effective.
Like all telehealth services, telePT is delivered in one of four ways, according to the Center for Connected Health Policy (CCHP).
|Modality||How it’s used||Example of this modality in action|
|Live video||To facilitate real-time interaction between a physical therapist and their patient.||A PT demonstrates exercises over a video call, and instructs the patient when it’s their turn. PTs might also consult other practitioners via video, such as yoga instructors or pelvic floor experts.|
|Remote patient monitoring (RPM)||To track the patient’s progress virtually.||A patient wears a FitBit and reports the average number of steps they take daily to their PT.|
|Store-and-forward||To transfer medical records and other health data using a secure electronic platform.||A patient uploads their medical history or most recent X-ray to an online portal, and a PT sends session notes via the same portal.|
|Mobile health||To transmit health information using a smartphone or tablet.||A PT texts a patient to let them know their Home Exercise Plan (HEP) is ready.|
What’s changed during COVID-19?
While telehealth physical therapy isn’t new, it’s become a popular way for PTs to see patients who need continued — not emergent — care.
What are the benefits of virtual physical therapy?
Virtual health sessions including telePT are now the standard way to get care — at least for the foreseeable future. As APTA clarifies: “Telehealth will not replace clinical care. However, it will give PTs the flexibility to provide services in a greater capacity.”
The biggest benefits include:
- Convenient and often cheaper than an in-person session.
- Helps patients and PTs stay safe and healthy and avoid exposure to COVID-19.
- Allows patients to receive treatment in the comfort of their own homes.
- Increases communication between PTs and patients through online platforms.
- Opens up more appointment times.
- Makes physical therapy more accessible for those who live in areas where PTs are lacking.
- Gives PTs a chance to assess the safety and accessibility of their patients’ homes.
- Decreases dependency between patients and their PTs, which may speed up their recovery.
Limitations of telehealth physical therapy
On the flipside, telePT has its downsides. These include:
- Lacks the manual adjustments that are often key to recovery, such as stretching, manipulating and putting pressure on a patient’s joints or muscles.
- Limits access to therapeutic modalities, such as ice, heat and electrical nerve stimulation machines — though some clinics are starting to make these available to patients at home.
- Forces PTs to get creative without the help of cables, assistive devices and other special equipment.
- Can be challenging to make an initial diagnosis or evaluation. Depending on the severity of your condition, you may end up having to visit your PT in person.
- Not always covered by insurance.
Conditions telePT can help with
TelePT focuses on physical rehabilitation, and PTs treat people with a wide range of injuries, conditions, disorders and disabilities.
These are some of the most common ones:
- Headaches and neck pain
- Joint and muscle pain, such as arthritis, sprains and muscle tears
- Back pain, including slipped discs
- Sports injuries, like tennis elbow, concussions and achilles tendonitis
- Foot pain, such as plantar fasciitis
- Hand disorders, like carpal tunnel syndrome
- Jaw pain, including TMJ
- Women’s health and pelvic floor dysfunction
- Neurological conditions, including stroke, multiple sclerosis and parkinson’s disease
- Pediatric conditions, like development delays, cerebral palsy and muscular dystrophy
- Poor balance and gait
- Post-surgical rehabilitation, such as recovery after a joint replacement
- Traumatic injuries, such as head injuries caused by car accidents
What can’t be treated with telePT?
TelePT isn’t suitable for these situations:
- Any urgent conditions — if you have an emergency, call 911
- Injuries that require deep tissue massage, like severe muscle strains and sprains
- Injuries that require electrical stimulation therapy
- Injuries that need to be diagnosed with an X-ray or ultrasound
How to set up your virtual physical therapy session
For a successful telePT session, follow these tips:
- Find a quiet, well-lit area in your home. Your time with your PT is limited, so maximize it by eliminating distractions.
- Lay out a mat and clear some space around it. You’ll need room to lie down, stretch, walk and turn around so your PT can see how your body moves.
- Test your tech. Check your internet connection and make sure you have clear audio. It’s worth playing around with a few camera angles to ensure your PT has the best view of your body.
- Grab any props before the session. Your PT will let you know what you need, which could include water bottles, tennis balls or dumbbells.
- Wear form-fitting clothes, like workout gear. That way, you can move around comfortably and your PT can closely watch your form. If you have a specific injury, try to make sure that area is uncovered. For example, wear a tank top if you’re treating a rotator cuff injury.
What does a physical therapist do?
According to the American Physical Therapy Association (APTA), PTs diagnose physical abnormalities and design treatment plans to help people:
- Improve their mobility and balance
- Manage pain and chronic conditions
- Recover from injuries and surgery
- Prevent future injuries and disorders
Does insurance cover telehealth physical therapy?
Private health insurance companies, Medicare and Medicaid have their own guidelines around telehealth, including physical therapy.
The information below is general. For the most accurate answer, call your insurer’s benefits department and ask about their telemedicine reimbursement policies.
|Type of insurance||How it treats telePT|
|Private health insurance||Most major health insurers cover telemedicine, and many have increased their networks during the COVID-19 pandemic, according to America’s Health Insurance Plans (AHIP).|
The list includes:
Many employers include telehealth as part of their health insurance plans, so check the fine print of your policy. If that’s the case, your employer may subsidize your consultation costs.
|Medicare||Telephysical therapy isn’t covered by Medicare, according to APTA.|
But the association is advocating for legislation under the CONNECT for Health Act that would expand the use of telehealth services to include PT. We’ll update this page as we learn more.
|Medicaid||Each state has its own rules and regulations surrounding telePT and telerehabilitation.|
All states have some coverage for telemedicine, but you may not be able to access the full suite of telePT services — like extended video consults and remote patient monitoring — under Medicaid.
How to find a telehealth physical therapist
Your doctor may refer you to a practitioner if you have an injury, condition, or disability that requires physical therapy.
Otherwise, you can search for one on your own using APTA’s online directory. Consider booking an initial consultation to make sure you like the PT’s personality and style before scheduling more sessions.
Do I need a doctor’s referral?
It depends on where you live.
Most states allow you to visit a PT via “direct access,” which means you don’t need a doctor’s referral to book an appointment, according to APTA. That applies to telePTs, too.
These states include:
- District of Columbia
- New Hampshire
- New Jersey
- New Mexico
- New York
- Rhode Island
- South Carolina
However, there are restrictions. For example, some states limit the number of visits you can schedule without a referral, while others require a referral if you need a special procedure, such as a needle EMG.
In Alabama, Missouri and Mississpi, direct access is limited to certain patients, such as those with a previous medical diagnosis.
What are my alternatives?
If you don’t have a private space at home or a stable Internet connection, you still have options to get physical therapy.
- Mobile physical therapy. Some PTs are offering mobile services, where the PT sets up in-person sessions in the comfort of the patient’s home. The PT can bring any specialized equipment, and this limits exposure to just one person coming into your home.
- In-person. As more clinics and doctors’ offices reopen, going back to physical therapy may be an option for some. However, this is highly dependent on your city and state’s current guidelines.
Thanks to telehealth physical therapy, patients can continue to receive care and manage their pain and medical conditions, but it has its trade offs — like a lack of manual adjustments and less access to specialized equipment.
Most private health insurance companies pay for telePT, but Medicare doesn’t and Medicaid reimbursement varies between states.
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