Understanding your insurance benefits can be overwhelming; however, knowing your options can help you make the best decisions to ensure you are getting the most out of your insurance coverage. At Personal Care Physical Therapy, we ensure that our patients can maximize their benefits by navigating the ins and outs of insurance coverage for physical therapy, including educating our patients on Direct Access laws in Florida for Outpatient Therapy. See below for all you need to know about your insurance coverage!
Medicare: Medicare covers Outpatient Physical Therapy through their Medicare Part B Benefits at 80%, leaving the remaining 20% to the patient, supplemental or secondary insurance. The 20% coinsurance payment can range from $15-$34 per session, based on the type of visit (evaluation, follow-up, etc), as well as the length of time the therapist provided skilled therapy. Outpatient therapy is billed in treatment codes & length of time (minutes).
Self-Pay: The cost of a self-pay visit with a mobile physical therapist in Florida varies by location and expertise. Hourly rates can often range from $150-$250 per session in Florida. While that could seem pricier than a standard outpatient clinic that you drive to, the many benefits speak for themselves (eliminated drive times, personalized one-on-one treatment, VIP concierge experience, sped up recovery times, and unparalleled convenience).
Therapists can also provide you with a Superbill, or insurance-specific receipts, to submit to your insurance company for potential reimbursement. Reimbursement is based on each specific insurance plan.
Workers comp: If you are injured in a work-related accident, physical therapy can be covered through your worker's comp benefits.
Private Insurances: These are your common carriers such as Cigna, Aetna, BCBS, United Healthcare, etc. At Personal Care Physical Therapy, we’ve worked with various insurance plans and can guide you through the process to ensure you get the most out of your benefits. Some insurances require a referral or pre-authorization prior, so it is best to check with your insurance plan. If you have a PPO plan, you likely do not need a referral, while HMO plans always require a referral from your primary care physician before seeing a specialist, such as a Physical Therapist.
Frequently Asked Questions about Medicare Part B Benefits in Florida:
How many Physical Therapy or Occupational Therapy Sessions Does Medicare Allow?
Medicare will cover Outpatient PT & OT services as long as they are deemed "medically necessary", which can be determined by your primary care physician and/or your physical therapist.
How many Sessions A Week Can I Have?
Medicare typically covers Outpatient Therapy up to 3x a week per discipline.
Do I Need a Doctor's Referral to Receive Physical Therapy?
Florida is a direct access state, meaning you do not need a doctor's referral to begin therapy under Medicare. The Physical Therapist will perform an evaluation and will let you know if further testing is needed during the evaluation (such as an x-ray or MRI); however, oftentimes it is not required for a PT to diagnose or treat a patient effectively.
Will Medicare Cover Physical Therapy In My Home?
Yes, Medicare covers In-Home Therapy the same way as if you go to a clinic. There are no additional costs.
What Costs Am I Responsible for Under Medicare Part B?
Medicare has an annual Part B deductible ($257 in 2025) which you are responsible for as well as a 20% coinsurance, unless your supplemental or secondary policy covers it.
Can I Benefit The Same Way From In-Home Therapy as an Outpatient Clinic?
Yes! In-Home Therapy is more beneficial than a clinic as you are receiving one-on-one personalized attention in the comfort of your home, speeding up your recovery timeline. Mobile Physical Therapists can provide more hands-on treatment because they are focused on your care throughout the entirety of the session. At Personal Care Physical Therapy, we also bring the supplies to your treatment sessions and can provide Ultrasound Therapy, Electric Stimulation Therapy, Cupping, Dry Needling & more, the same way as an Outpatient Clinic would, but all in the comfort of your home. Check out our most popular services here.
In Florida, specifically in Port St. Lucie, Martin County, and Jupiter, we’ve seen that many people have access to more comprehensive coverage than they realize. At Personal Care Physical Therapy, we take the time to help our patients understand their local insurance options, making the process smoother.
For more information on Mobile Outpatient Therapy in Florida, or if you live in Port St. Lucie, Stuart, Palm City, Jensen Beach, Hobe Sound, or Jupiter and are looking for a Physical Therapist near you, call us at (772)-238-0702 to schedule an appointment. You can find more details about our Mobile Therapy Services here at Personal Care Physical Therapy on our Website. We proudly serve the Treasure Coast of South Florida!
We know insurance can be confusing, but you don’t have to navigate it alone! If you are ready to start therapy, our team at Personal Care Physical Therapy is here to help you understand your options, so you get the most out of your benefits without the stress.
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