Does Blue Cross Blue Shield cover physical therapy sessions?
Asked by: Dr. Norene Hamill | Last update: April 18, 2025Score: 4.8/5 (20 votes)
Do Blue Cross and Blue Shield pay for physical therapy?
Standard Option - You Pay
Note: Benefits are limited to 75 visits per person, per calendar year for physical, occupational, or speech therapy, or a combination of all three. Note: Visits that you pay for while meeting your calendar year deductible count toward the limit cited above.
How do I know if my PT is covered by insurance?
Review your policy documents to learn more about your insurance coverage. You can also contact your insurance provider directly. They can give you further details on your plan's coverage, limitations, and requirements to cover physical therapy services.
How much does Blue Cross Blue Shield cover for therapy?
If you choose a therapist who is in-network with Blue Cross Blue Shield, your therapy sessions likely cost between $15 - $50 per session, after you meet your deductible. The $15 - $50 amount is your copay, or the fixed amount that you owe at each therapy visit.
What is the best insurance for physical therapy?
Overview of Major Insurance Providers
Blue Cross, UnitedHealthcare, and others like Aetna and Cigna are among the top providers that individuals typically consider for physical therapy coverage. Each of these insurance companies offers different tiers of plans, ranging from basic coverage to more comprehensive options.
Does My Insurance Cover Physical Therapy? Definitions, Coverage and Payment
How many PT visits does insurance cover?
Know your limits
If you have a very low number of visits per year (sometimes 20-30) or you have a policy that combines physical, occupational, and speech therapy visits, you can also ask if there is any appeal process for this limit. It is rare, but some insurance providers may make exceptions for catastrophic cases.
How much is a physical therapy session with insurance?
Note that if you have insurance to cover physical therapy, you likely won't be paying the entire amount yourself. The average copay for a physical therapy visit is between $25 and $50.
Why is therapy not covered by insurance?
Provider Restrictions: Often, insurance plans will only cover therapy if you see a provider who accepts insurance that is "in-network," which limits your options and may not include your preferred therapist.
Does Blue Cross Blue Shield cover massages?
Some insurance companies that cover medically prescribed massage include BlueCross/Blue Shield, United Health Care, Cigna, and Aetna.
Why is my physical therapy not covered by insurance?
For example, a patient may have reached their maximum benefits for the year, or their policy may not cover certain services, such as physical or occupational therapy. Other eligibility issues include: Inactive or terminated insurance policies. Insufficient coverage for the service provided.
Do I have to pay a copay for physical therapy?
Most insurance companies cover a portion of the physical therapy bill and leave the rest for you to cover with a copay. This payment will need to be made for every PT session you attend. Ask your insurance company about your financial responsibility for PT before you make your first appointment.
Is PT insurance worth it?
In some dire scenarios, pet insurance could save the life of an animal that would otherwise be euthanized if its owner couldn't afford treatment. But if your pet rarely gets sick, you could end up paying thousands of dollars in premiums without getting much in return.
How do I check if my insurance covers something?
If you have any questions about what your plan covers, contact your insurance company. Member Services representatives are there to answer exactly these types of questions. They can tell you whether a doctor, prescription or service is covered, plus how much your insurance will pay.
Does Blue Cross Blue Shield cover therapy?
Yes, therapy covered by Blue Cross Blue Shield includes treatment for anxiety and related disorders, such as panic disorder, agoraphobia, and social anxiety.
How to find a therapist covered by insurance?
You can access an online directory of insurance companies or see a list of all the providers in your network on your insurance's website. You can also call your insurance company to determine if a therapist is in-network. It's important to consider your needs before deciding who you want to work with.
How much are therapy appointments without insurance?
The cost of therapy varies depending on various factors, such as the type of therapy, therapist, and the service provider. However, a person should generally expect to pay between $100 to $250 per session without insurance. Prices may differ depending on whether a person receives online or in-person therapy.
Does Blue Cross pay for physical therapy?
By choosing Blue Cross Insurance for your physical therapy needs, you can enjoy the benefits of continuity of care. This means that if you require ongoing treatment or multiple sessions, Blue Cross Insurance will support your treatment plan and provide coverage for the duration of your therapy.
Why would insurance deny physical therapy?
Common reasons for medical claim denials in physical therapy include: Lack of Medical Necessity: Insurers often deny claims if the therapy does not meet their criteria for medical necessity. Treatment plans must be well-documented and justified in terms of medical necessity.
Do most insurance cover physical therapy?
If you're in for a long recovery after an injury or surgical procedure, you're probably wondering if insurance will pay for physical therapy. The answer is yes — most insurance plans will cover medically necessary physical therapy services that are provided by a licensed physical therapist.
How often will insurance pay for a physical?
Additional primary care visits: Most health plans will cover you for 1 annual check-up with your doctor. Other visits during the same calendar year will likely not be covered as preventive.
How many physical therapy sessions do I need?
On average, it can take around a few weeks to a few months to complete physical therapy treatment depending on severity and how consistent you are in your care. On average patients see their PT for about 10-12 visits, and you continue your exercises after physical therapy appointments are done.
What is included in a PT plan of care?
According to the APTA, these plans should include “at minimum: (1) diagnoses; (2) long-term treatment goals; and (3) type, amount, and duration of therapy services.” But, you may also want to include short term goals and discharge plans to make the plan more meaningful to the patient as well as the providers.
Is it worth paying for a PT?
So, is it worth paying for a personal training sessions? The answer is, it depends. If you have the financial resources and are committed to achieving your goals, then hiring a personal trainer can be a great investment. They can provide you with the guidance, support, and motivation you need to succeed.