The short answer: yes, most insurance plans cover physical therapy — and EverStrong PT accepts most major plans. The longer answer involves deductibles, copays, visit limits, and prior authorization. Let's decode all of it.
Insurance Plans We Accept at EverStrong PT
We are in-network with the following plans:
- BlueCross BlueShield of Tennessee
- Aetna
- UnitedHealthcare
- Medicare Part B
- Medicaid / TennCare
- Cigna
- Humana
- Tricare
- Workers' Compensation
- Auto/personal injury (PIP)
Don't see your plan? Call us at (423) 367-7670 — we may still be able to accept it or help you navigate out-of-network benefits.
We verify your insurance benefits before your first appointment at no charge. We'll tell you exactly what your plan covers, your expected copay, and whether prior authorization is needed — so there are no surprises.
Key Insurance Terms Explained
Deductible
The amount you pay out-of-pocket before your insurance starts covering costs. If your deductible is $1,500 and you haven't met it, your first PT sessions will likely be billed at a discounted in-network rate until the deductible is satisfied.
Copay
A fixed amount you pay per session after your deductible is met. Common PT copays range from $20–$60. Some plans use coinsurance (a percentage) instead of a flat copay.
Out-of-Pocket Maximum
The most you'll pay in a plan year before insurance covers 100%. Once reached, all covered services including PT are fully covered for the rest of the year.
Visit Limits
Many plans cap PT at 20–60 visits per year. Some plans have no visit limit. We track your visits and alert you before you approach your limit so you can plan accordingly.
Prior Authorization (PA)
Some plans require insurance approval before covering PT. EverStrong PT handles all PA requests on your behalf — this is standard practice and typically approved within 1–3 business days.
Medicare Coverage for Physical Therapy
Medicare Part B covers outpatient physical therapy with no annual cap (the cap was permanently eliminated in 2018 under the Bipartisan Budget Act). Key details:
- Medicare pays 80% of the approved amount after your Part B deductible
- You pay the remaining 20% (or your Medigap/secondary insurance may cover this)
- Services must be deemed "medically necessary" and provided by a qualified therapist
- A physician order is not required, but Medicare does require a plan of care certified by a physician within 30 days
Medicaid / TennCare Coverage
Tennessee Medicaid (TennCare) covers physical therapy for medically necessary conditions. Coverage specifics depend on which TennCare managed care organization (MCO) you're enrolled in (BlueCare Tennessee, United American Insurance TennCare, or Amerigroup). EverStrong PT is in-network with TennCare MCOs — call us to confirm current participation.
What If You Don't Have Insurance?
We offer competitive self-pay rates for uninsured patients. Many people find that paying out-of-pocket for 6–10 focused sessions is far more cost-effective than months of prescription medications or specialist co-pays. Ask about our self-pay packages when you call.
Don't Let Insurance Stop You
EverStrong PT accepts most major plans and handles all verification and pre-authorization for you. Start your recovery this week.
Frequently Asked Questions
Yes. Medicare Part B covers outpatient PT with no annual cap. You pay 20% after your Part B deductible. Some Medicare Advantage plans have different rules — we verify your specific plan before your first visit.
Typical copays range from $20–$60 per session. If you haven't met your deductible, you'll pay more early in the year. EverStrong PT verifies your exact benefits before your first appointment.
Insurance requires medical necessity documentation for coverage. At EverStrong PT, we handle all documentation — most patients with pain or functional limitations qualify.
