Questions people telephone about

Usually not. New York's direct access law lets a physical therapist who has been licensed at least three years treat you without a referral for ten visits or thirty days, whichever comes first — every clinician here qualifies, so you can book and be treated on the same day. Two exceptions matter and they catch people out: an evaluation on its own does not count as one of the ten, and direct access does not apply to Workers' Compensation, No-Fault or Medicare, all of which need a referral from the very first visit. We are also required to tell you in writing at the start that treatment without a referral may not be covered by your plan, and we do that before you are treated rather than after.

If you are paying yourself, $190 for the initial evaluation and $140 for each treatment visit, published on the pricing page and not negotiable downwards for some people and not others. If you are using insurance, what you pay is your plan's copay or coinsurance and we will check the actual number before your first visit rather than after your sixth. What we will not do is sell you a discounted block of twelve sessions in advance, because that gives us a reason to use all twelve.

Every condition page on this site publishes a typical range, and you get an estimate specific to you in writing at the first appointment. Most mechanical back and neck problems run six to twelve visits. Positional vertigo is often one to three. An ACL reconstruction is thirty to fifty over nine to twelve months. The estimate can be wrong; what it cannot be is missing, and we reassess at visit four so that a course which is not working gets changed rather than extended.

No, and no physical therapist in New York may. The State Board has held dry needling to be an invasive procedure outside the physical therapy scope of practice, and acupuncture needles may be used here only by licensed acupuncturists and by physicians and dentists certified to do it. New York is one of only four states that take that position, which is why clinics that relocated from elsewhere sometimes still advertise it. If it is what you want, we will tell you who is licensed to provide it.

A licensed physical therapist evaluates you, writes your programme and is the only person who may change it. That is the law rather than our policy: a physical therapist assistant is barred from evaluating, interpreting or altering a plan of care, and an unlicensed aide may not provide physical therapy at all. Here you see the same named clinician each visit, in their own room, and if that person is away you are told before you arrive rather than handed to whoever is free.

Rarely, and never as the substance of a plan. The World Health Organization's 2023 guideline recommends against therapeutic ultrasound in routine care for chronic low back pain and NICE recommends against offering it at all for back pain; the Cochrane review found an effect too small to matter. These machines persist because they bill well and occupy no clinician, and a course built around them is a course built around the billing. What changes tissue is loaded exercise, and that is what you will be given.

Most plans do, with a copay or coinsurance and usually a cap on visits per calendar year — and that cap is often lower than the course a condition actually needs. We verify your benefit before the first visit and tell you the number, then plan the course around it, which sometimes means front-loading the hands-on work and giving you more to run yourself. We are in network with several major carriers; telephone with your card and we will tell you where you stand in a few minutes.

Comfortable clothes you can move in and that give access to the part that hurts — shorts for a knee, a vest for a shoulder. Your insurance card. Any imaging reports you have, though not the discs. A referral if you are on Workers' Compensation, No-Fault or Medicare. And if it is a No-Fault claim, the claim number, because the filing window after a motor vehicle accident is strict and it starts on the day of the accident rather than on the day you decide to seek treatment.

Almost certainly not on its own. Disc bulges, degeneration and rotator cuff tears appear in very large numbers of people with no symptoms whatsoever, and the proportion rises with age in people who feel entirely well — which means a report can be completely accurate and still not be the reason you hurt. What changes the answer is progressive weakness, loss of bladder or bowel control, or a pattern that is not improving over a reasonable course. Those we escalate immediately. The rest we treat.

Yes, and both run on their own rules. Workers' Compensation follows the New York Medical Treatment Guidelines, which broadly authorise twelve visits after an injury; more requires a Prior Authorization Request, which we file and tell you about either way. No-Fault covers treatment after a motor vehicle accident and has a strict application deadline running from the date of the accident. Neither scheme allows direct access, so both need a referral from an authorised provider before your first visit.

Different licences, different training and a different theory of what is wrong. We do not perform spinal adjustments as a chiropractor does; we assess how you move, load the tissue that needs loading and build the capacity back. Both professions treat back pain and both have people who do it well. What we will not do is tell you the other one does not work — we will tell you what we do, what the evidence for it is, and when your problem is not ours at all.

No. There is no pool in this building and we are not going to describe one. Where water-based work is genuinely the right answer — some post-operative loading restrictions, some inflammatory arthritis — we will say so and tell you where to find it. A clinic listing a service it cannot provide is how people end up booking an appointment to be told no on arrival.

Sixty minutes, every visit, with the clinician you booked. That is a deliberate choice and it is the reason our diary looks emptier than a clinic running three patients an hour on twenty-minute overlaps. One hour of one person's attention is what the treatment actually consists of, and it is also what makes the billing honest: Medicare's eight-minute rule counts direct one-to-one time, and a clinician shared between three rooms cannot honestly report much of it.

Then we say so, at the first appointment where possible, and we tell you what to do instead. Some problems are surgical, some are medical, and some symptoms mean stop today and see a physician — unexplained weight loss, night pain that does not change with position, fever with back pain, progressive weakness, a change in bladder or bowel control, or new bone pain with a history of cancer. We would much rather make that referral ten times unnecessarily than miss it once.