Insurance for Physical Therapy

Specialized Physical Therapy accepts most major insurance plans in Massachusetts; please see the up-to-date list below for the insurance plans we accept.  As an alternative payment type to insurance for premium physical therapy service, we accept cash, checks, and credit cards for those patients who strive to reach optimal health and recovery from some of the most qualified therapists in the Boston area.

Written Prescriptions and Authorizations for physical therapy are required for all Tufts Health Plans, BCBS HMO plans, BCBS Medicare Advantage HMO plans, and United Healthcare Medicare Advantage POS/HMO plans.  Please have your Primary Care Physician (PCP), not a specialist (i.e. your orthopedic surgeon), to authorize treatment for Physical Therapy (PT) through your insurance company, and fax us a copy when this is complete to: 866-949-9835. The referral department at your PCP clinic needs the first four things below in order to authorize PT treatment (otherwise, your insurance will not pay for your PT treatment) and complete the insurance authorization with your insurance.  Please be sure to follow-up with your PCP every two days until they complete it; most well-managed PCP clinics can do on the spot authorizations over the phone or day of.

1. Clinic Name: We are Specialized Physical Therapy, SPT, located in both North Reading, MA and Stoneham, MA.
2. Our Group National Provider Identifier (NPI) Number:   156-871-0903.
3. Your start date for the initial evaluation.
4. For BCBS members, please request 26 visits from your PCP; for Tufts members, please request 9 visits from your PCP.
5. For GIC Unicare, Cigna, Workers’ Compensation, BCBS Anthem, Health Plans, Aetna, and United Healthcare authorizations, SPT will make the initial request for your PT authorization if needed.  Some authorizations need to be requested before you initial evaluation and others need to be requested after your initial evaluation at our clinic.

A Written Prescription, no more than 30 days old, for Physical Therapy is required regardless of insurance payment type (i.e. health insurance, auto accidents, or workers’ compensation). Please bring the prescription to your first visit or have your PCP fax it to our clinic: 866-949-9835.  Tip:  What is the purpose of a Written Prescription from your doctor?  1)  It protects your financial interests in the event your insurance company decides to audit your account.  2)  It allows us to immediately start our work by treating the right injury or pain center since we know your diagnosis is 99% accurate since it is coming from a trained professional thereby not wasting your time or ours. 3)  Managed insurance companies that require physical therapy authorizations also demand a written prescription for the continuation of care.

• • Blue Cross and Blue Shield (BCBS of MA or out of state)
  • BCBS MEDEX (Medigap)
  • BCBS Federal
  • BCBS Medicare Advantage Plans
  • Blue Benefit Administrators of MA
  • Neighborhood Health Plan (AllWays Health Partners)
  • Harvard Pilgrim Health Care (HPHC)
  • Health Plans  (A Harvard Pilgrim company)
  • Tufts Health Plan (THP)
  • Tufts Health Plan Navigator
  • Tufts Health Plan CareLink
  • Tufts Medicare Preferred (TMP)- A Medicare Advantage Plan
  • Tufts Total Health Plan
  • Medicare Part B
  • Medicare for Railroad Workers and Their Families
  • Tricare East – Humana Military (Authorized-In-Network)
  • Cigna
  • Aetna
  • Meritain Health (an Aetna Company)
  • GIC UniCare State Indemnity Plan
  • UnitedHealthcare (UHC)
  • UnitedHealthcare Medicare Advantage Plans
  • UMR (a UnitedHealthcare Company)
  • AARP Medicare Plans by UnitedHealthcare
  • Local 103 IBEW (Medicare Supplement Insurance only)
  • Workers’ Compensation – not accepted at this time.
  • Auto Accidents– not accepted at this time.
  • Insurances we do not accept:  Auto Accident, Workers’ Compensation, MassHealth, MultiPlan, Fallon, Minuteman Health, Tufts Health Together, Tufts Health Unify, and Tufts Health Direct either as primary or secondary insurance. However, we do accept cash payment at the time of service as an option.

  What’s Our Top Four Health Insurance Recommendations for Your Family?

  All health insurance companies provide basic physical therapy treatment for their members. However, some health insurance companies, like all businesses – are better than others. As a provider, we have the opportunity of treating our patients directly – which we are 100% passionate about – and working with representatives from many insurance companies in Massachusetts. We take pride in working with patients to help maximize their insurance benefits, so how the insurance company works with SPT as the provider is important as well. Insurance benefits change frequently, but as of 2018, when we consider 1)  how many physical therapy treatments are available to patients and the restrictions applied to them, 2) whether or not a patient needs an authorization or referral which may impede treatment when waiting on the a patient’s doctor or their insurance to authorize it , 3) how much time it takes to contact the insurance company to verify coverage or ask about a claim for example, 4) the competency of the insurance representatives we talk with, and the rules, policies, and 5) the restriction insurances place on providers clear winners emerge. With that said and in no particular order, our top four picks – in our humble opinion – for the best insurance to have to ensure the very best physical therapy treatment for your families health are:

  • Neighborhood Health Plan (now AllWays Health Partners)
  • Blue Cross Blue Shield PPO (BCBS)
  • Tricare East – Humana Military
  • GIC Unicare

  Self-Pay Cash Rates

  • 60 minute Initial Evaluation:  $178 each
  • 30 minute follow-up treatment:  $89 each
  • 5 Pre-Paid Treatments:  5% discount ($422 total; follow-up treatments only)
  • 10 Pre-Paid Treatments:  10% discount ($801 total; follow-up treatments only)
  • *Prices are subject to change without prior notice

  Payment Types Accepted

  • Cash
  • Personal and Business Checks
  • HSA and FSA debit cards
  • MasterCard
  • VISA
  • American Express
  • Discover
  • PayPal

  Convenient Physical Therapy Clinic Location: North Reading, MA

  Specialized Physical Therapy is conveniently located in North Reading, MA. We proudly serve residents in the neighboring communities including: Andover MA, Reading MA, North Andover MA, Wilmington MA, Boxford MA, Burlington MA, Woburn MA, Lynnfield MA, Melrose MA, Danvers MA, Middleton MA, Topsfield MA, Wakefield MA, and Methuen MA. We offer free and spacious parking located within a few steps away from our clinic’s door.

  
  

  Schedule Your Appointment Today to Regain Freer Movement and Healthy Living!

  Specialized Physical Therapy practices a comprehensive approach to total muscle, joint, and spine health. We are the preferred physical therapy clinic in Greater Boston, because we offer an extensive range of physical therapy services designed to restore your physical strength and mobility while reducing your pain. Our physical therapy clinic sets itself apart by:

  • We have helped thousands of patients with low back pain, sciatica, disc bulge, shoulder pain, shoulder impingement, frozen shoulder, hip pain, hip replacement, hip impingement, knee pain, knee replacement, ACL tears, MCL strains, LCL strains, ankle pain, and much more. Our Physical Therapy experts can help you with your range of motion, strength, balance, pain, injuries, and more. Call Now to take control of your health!
  • Providing proven techniques for alleviating minor, major, acute, and chronic pain.
  • Specializing in sports medicine, manual therapy, post-surgical care, auto accidents, workers compensation, prenatal and postpartum conditions, orthopedic injuries and overuse injuries.
  • Maintaining a clean, comfortable, private and quiet clinic, making it ideal for private consulting, educating and performing the latest physical therapy techniques.
  • Focusing on your individual needs, not the bottom line, because we are a small, physical therapist-owned and family-oriented clinic.
  • Treating one patient at a time in our private treatment room to make sure that you get the personalized care and attention you need.
  • Completing your treatment from start to finish with only exceptional doctorate trained and fully licensed Massachusetts physical therapists that have excellent skills, breadth of knowledge, and invaluable experience to help you reach your goals and succeed.
  
  

  Read Our Patient Successes!