Physical Therapist BCBS Insurance Coverage and Benefits

As a physical therapist, it's essential to understand the insurance coverage and benefits offered by Blue Cross Blue Shield (BCBS). Fortunately, many BCBS plans cover physical therapy services, including manual therapy, exercise, and education.

BCBS plans often have a copayment or coinsurance for physical therapy services, which can range from $20 to $50 per session. Some plans may also have a deductible that must be met before coverage begins.

In addition to copayments and coinsurance, BCBS plans often have an out-of-pocket maximum, which is the maximum amount you'll pay for healthcare expenses in a calendar year. This can range from $1,000 to $5,000 or more, depending on the plan.

Many BCBS plans also offer a network of physical therapists who have contracted with the insurance company to provide services at a discounted rate. This can help reduce out-of-pocket costs for patients.

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As an Anthem Blue Cross Blue Shield patient, you can schedule a therapy session with just a few hours’ notice, making it easy to fit into your busy schedule.

Your co-pay remains the same, so you don't have to worry about extra costs for the convenience of in-home physical therapy.

You can enjoy about 3x more 1:1 time with Luna PTs than at clinics, which helps you achieve your goals faster and more effectively.

Having appointments later in the evening, after work, is much easier, as one patient noted, making it possible to balance your treatment with family responsibilities.

Our therapists are available for in-home physical therapy appointments across the United States, making it convenient to receive care no matter where you live.

You don't need a prescription to start physical therapy, so you can see a therapist without a referral, and we'll work with you to communicate your progress with your physician.

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As a physical therapist with BCBS, you'll need to understand the Medicare authorization process. This process ensures patients receive necessary services without financial burden.

Medicare requires a pre-authorization for certain services, such as physical therapy sessions. This means you'll need to submit a request to Medicare before providing treatment.

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For patients with Horizon Blue Cross Blue Shield, prior authorization requests for physical and occupational therapy services must be submitted online using the NaviNet tool as of August 24, 2018.

Claims processing and reimbursement for services provided are subject to member eligibility and all member and group benefits, limitations, and exclusions.

This change applies to all Horizon Managed Care and Medicare Advantage plans, including members enrolled in the Horizon Medicare Advantage NJ DIRECT (PPO) plans.

You can use the online Utilization Management Request Tool to initiate requests for prior authorization, but it can't be used to create referrals for PT/OT services.

If you're unsure about your specific insurance coverage or payment obligations, you can contact Twin Boro Physical Therapy at 877-304-3000 for assistance.

If this caught your attention, see: Horizon Bcbs Plans

Medicare requires a signed plan of care for physical therapy. Your Luna therapist will create a plan of care during your first visit, and the Luna team will work with your doctor to get it approved.

You'll need a new plan of care established every 90 days or 10 visits, whichever is sooner.

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If you're a resident of Sarasota, you'll want to know about the local physical therapy providers who accept Blue Cross Blue Shield (BCBS). Cross and Shield Providers in Sarasota are limited, with only a handful of options available.

One notable provider is the Sarasota Memorial Hospital Physical Therapy Department, which has a team of experienced physical therapists who work with BCBS to provide care. The department offers a range of services, including orthopedic and sports physical therapy.

Another option is the Bayfront Physical Therapy Center, which has been serving the Sarasota community for over 20 years. They have a team of licensed physical therapists who accept BCBS and offer services such as manual therapy and exercise programs.

If you're looking for a more specialized approach, consider the Sarasota Sports Medicine and Orthopaedic Center. They have a team of physical therapists who specialize in sports medicine and orthopedic care, and work closely with BCBS to ensure that patients receive the care they need.

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