Last month, a bill was signed into law that allows Illinois residents direct access to a physical therapist. In this blog post, we’ll address your questions on direct access to physical therapy in Illinois.

1) What is Direct Access?

“Direct Access” is the removal of physician referrals, as mandated by state law, to access services provided by physical therapists. This means you can now access a physical therapist WITHOUT a script or referral from your physician. This makes Illinois the 45th state to allow direct access.

There are three levels of direct access to physical therapists:

  1. Unrestricted access
    • Patients may visit a physical therapist as much as they need with no restrictions or referrals.
    • 18 states have access to this level.
  2. Provisional access
    • Patients can access evaluation and treatment with some provisions such as a time or visit limit, or referral requirement for a specific treatment intervention
    • 27 states have access to this level, including Illinois.
  3. Limited direct access
    • Treatments are limited to certain patient populations (i.e. past medical diagnosis) and circumstances (i.e. physician referral is necessary for physical therapy).
    • 5 states have access to this level.

2) How Does Direct Access Affect Me?

You can now access physical therapy services without a referral from your physician.

Physical therapy is not solely reserved for those who are injured and in pain. As experts of human movement, we also provide performance enhancing services for athletes of any age, activity and sporting level. We’ve worked with marathon runners, basketball players, trapeze artists, baseball players, golfers, Olympic weightlifters and many more.

We strongly believe in holistic health and collaboration. We promise to always communicate with your primary care team about your physical therapy status.

3) Will Insurance Cover My Direct Access Visit?

At this time, there is no straightforward answer for this question. The new law gives healthcare insurance providers the discretion to allow direct access to physical therapy, but it is not required. Therefore, we recommend that you contact your healthcare insurance provider to confirm if a referral is still required; prior to your visit.

Keep in mind: If your healthcare insurance provider does not cover physical therapy services, we do offer self-pay options. Contact us for further details.

4) What Happens If I Don’t See Improvements During Physical Therapy?

If you are not seeing improvements during physical therapy, we will refer you to your physician for further evaluation.

Under the Illinois law, you will be referred to your physicians:

  • If there are no measurable or functionable improvement after 10 visits or 15 business days.
  • If you return for services for the same or similar condition after 30 calendar days following discharge by your physical therapist.
  • If your condition is evaluated and determined to be beyond the scope of practice of your physical therapist.

At REAL pt, we aim to be your lifelong healthcare partner. If you are in need of treatment for injury/pain or if you are looking to enhance your sporting performance, contact us below to schedule your free wellness consultation.