Body Mechanix

What is direct access in California?

In California, direct access means you can see a physical therapist without first getting a referral from a doctor.

What happens during my first visit?

Please arrive with your paperwork completed (available on our website). Bring your referral if you have one—referrals are not always required. We will also make a copy of your physical insurance card. You will meet with your physical therapist for an initial evaluation. During this visit, the therapist will review your medical history, current concerns, pain levels, daily limitations, and your goals for therapy, as well as any relevant medications or tests. The therapist will then perform a physical assessment, which may include checking movement, strength, posture, nerve function, and areas of tenderness. Based on this evaluation, your therapist will develop a personalized treatment plan with you, outlining visit frequency, length of care, home exercises, goals, and what to expect after therapy.

What if I do not have a referral from a doctor?

In California, direct access means you can see a physical therapist without first getting a referral from a doctor. You may receive physical therapy for up to 45 days or 12 visits (whichever comes first) without a physician’s referral. During this time, your physical therapist will evaluate your condition and begin treatment if it is safe and appropriate. If you need care beyond that limit, your physical therapist must obtain a referral or communicate with a physician to continue treatment.

What does the treatment include?

Treatment includes exercise, hands-on care, and education to help patients manage pain and stay active. Only licensed physical therapists provide this care. Most insurance plans cover physical therapy, and many patients can start without a doctor’s referral.

How does the Physical Therapy billing process work?

Billing for physical therapy services is similar to what happens at your doctor's office. When you are seen for treatment, the physical therapist bills your insurance company, Workers' Comp, or charges you based on CPT codes. Those codes are transferred to a billing form that is either mailed or electronically communicated to the payer. The payer processes this information and makes payments according to an agreed-upon fee schedule. An Explanation of Benefits (EOB) is generated and sent to the patient and the physical therapy clinic with a check for payment and a balance due by the patient. The patient is expected to pay the balance if any. It can take time; payments may be delayed, but typically completes in 60 days or less, though six months is not uncommon.

What is your appointment cancellation policy?

We require 24 hours notice before cancelling an appointment. If you cancel within that 24 hour period, you are subject to a $50 cancellation fee. If you do not show up to your appointment you are subject to a $75 no show fee.