Frequently Asked Questions

Welcome to the Ashland/Hopkinton Physical Therapy Website! At our clinic we strive to exceed your expectations in the care we provide and to continue to be your first choice for all your PT needs. If you are a first time physical therapy patient you may have a few questions. Below is our FAQ section, feel free to scroll through to see if any may be of help to you! Please do not hesitate to contact us (the contact tab will give you all the information you need) with any questions you still have.

What is physical therapy?
What types of diagnoses can be treated?
What is a referral?
What is a prescription?
What does a typical visit consist of?
How many visits will I need?
My insurance company said I have 60 visits, can I use all 60 for this injury?
What is medical necessity?
What do I do when my insurance company say physical therapy is no longer medically necessary?
Do I have a co-pay or deductible?

What is physical therapy?

Physical therapy is a type of rehabilitation to help restore mobility, reduce pain and improve function to allow patients to return to their normal daily activities. Here’s what patients can expect to receive:

  • - Education on how to manage their symptoms
  • - Instruction in therapeutic exercises tailored to their injury
  • - Manual (hands-on-therapy) specific to their injury
  • - Modalities such as heat/ice, ultrasound, and electrical stimulation may be used depending on the diagnosis and whether current evidence-based research supports it
  • - 45 minutes of one on one treatment with one of our physical therapists

What types of diagnoses can be treated?
  • - Joint replacements or following surgical procedures including ACL repairs, Arthroscopic Knee Surgery, Rotator Cuff/Labral/debridement repairs, Lumbar and Cervical Fusions, Total Knee Replacements, Total Hip Replacements, and many others.
  • - Muscle pain, ligament and joint pain and other injuries including ligament sprains, muscle strains, impingement, tendonitis, bursitis
  • - Vertigo, Dizziness, BPPV
  • - Cervical/Thoracic/Lumbar injuries including bulging/herniated discs, spondylolisthesis, spondylolysis, degenerative disc disease, stenosis, facet joint impingement

What is a referral?

A referral is what is required to be sent from your doctor’s office to the insurance company to request the coverage for physical therapy. Not all insurances require a referral. Many PPOs do not require referral, however HMOs do. If you are unsure whether one is required prior to your visit, please contact your insurance company.

What is a prescription?

A prescription is a signed note from your doctor with the diagnosis to be treated and a possible time frame (2x/week for 6 weeks). A prescription is required by insurance companies and must be presented at your first visit for your insurance company to pay for treatment. It can be provided by your PCP or a specialist.

What does a typical visit consist of?

Your first visit will consist of questions to obtain a thorough health history and physical movements to determine your physical therapy diagnosis and to help the physical therapist create a custom plan of care for your specific injury. After the evaluation the physical therapist will recommend a duration and frequency of physical therapy visits. Future sessions will focus on return to function and developing a home-based program.

How many visits will I need?

The average physical therapy duration is 8-12 visits. Most patients attend 2x/week at the beginning and then progress to once per week or every other week by the end of treatment. However, your therapist with personalize your plan of care after the evaluation is performed and be able to better inform you of the amount of visits that may be needed.

My insurance company said I have 60 visits, can I use all 60 for this injury?

Although your insurance company does cover a pre-set amount of visits or money towards physical therapy per year, it is unlikely that they will pay for that many visits. They will pay for the maximum number of visits deemed 'medically necessary' for your injury.

What is medical necessity?

PT services must focus on a return to daily and necessary function. The patient must show measurable progress and compliance with the home exercise program. Insurance companies feel an acceptable level of return to baseline function is generally 80%-90% of the prior level of function.

What do I do when my insurance company say physical therapy is no longer medically necessary?

You have multiple options as your physical therapy sessions come to a close. The above medically necessary guidelines do not apply if you choose not to use your health insurance. We would be glad to work with you without these restrictions to help you achieve your goals as a cash-pay service. We further encourage you to use the services of a personal trainer or massage therapist to help you achieve your final goals and maintain your fitness once physical therapy is over. We can gladly make recommendations for you.

Do I have a co-pay or deductible?

It is best to contact your insurance company prior to coming to your evaluation. Once you have started you are expected to pay your co-pay at the time of service. If you have a deductible, we suggest making payments towards your deductible at each session and will help to defer a high balance as your covered services come to an end.