Mon to Fri, open as early as 7 AM531 Virginia Street, Buffalo, NY
No referral needed for most plans(716) 332-4838

Start Physical Therapy Without a Referral

With most plans, you can start without a referral. Here is New York's direct access rule in plain words, when you still need one, and how to get ready.

Request an appointment(716) 332-4838
How will you pay for physical therapy?

No referral needed to start for most plans

New York lets you see a licensed physical therapist for up to 10 visits or 30 days, whichever comes first, without a referral. Some plans still require one before they will pay, so we check your benefits first. You will sign a short notice about coverage at your first visit.

How direct access works

No referral needed to start

Medicare does not require a referral, but your physician, nurse practitioner or physician assistant certifies the plan of care your therapist writes. We coordinate that for you. Some Medicare Advantage plans also need prior authorization.

Medicare physical therapy

A referral is required

No-Fault covers physical therapy with a referral from your provider. Bring your claim number and adjuster's details, and notify your auto insurer in writing within 30 days of the accident.

Car accident physical therapy

A referral is required

Workers' Compensation covers physical therapy with a referral from your treating physician, physician assistant, podiatrist or nurse practitioner. Bring your Workers' Compensation Board case number and carrier information.

Workers' Compensation physical therapy

No referral needed to start

Under direct access you can begin right away. Self-pay rates are $100 for the evaluation and $70 for each follow-up visit.

Pricing and self-pay

Yes, with most plans you can call us directly. In New York, you can book your first physical therapy appointment without seeing a doctor first, thanks to the state’s direct access law. At Lake Erie Physical Therapy in Buffalo, that means a licensed physical therapist can evaluate you and start treatment without a prescription, within limits the law sets. Here is the rule in plain words, the situations where you still need a referral, and what happens when you come in.

New York’s direct access rule, in plain words

  • 10 visits or 30 days, whichever comes first. A licensed physical therapist can treat you without a referral from a physician, dentist, podiatrist, nurse practitioner or licensed midwife for up to 10 visits or 30 days.
  • The clock starts with treatment. The 30 days begin with your first treatment and include weekends and holidays. Your evaluation alone does not count as one of the 10 visits unless you also receive treatment that day.
  • An experience requirement. The physical therapist must have practiced full time for the equivalent of at least three years.
  • A signed notice. Before treatment without a referral, you sign a form acknowledging that your health plan or insurer may not cover physical therapy without a referral. You keep a copy.
  • Then a referral. To continue past 10 visits or 30 days, you will need a referral.

Direct access is a licensing rule, not an insurance promise. Some insurers still require a referral before they will pay, so call the number on your card and ask. You can also check the plans we accept.

When you still need a referral or a signature

  • Car accidents (No-Fault): No-Fault pays for physical therapy only with a referral. See physical therapy after a car accident.
  • Work injuries (Workers’ Compensation): You need a referral from your treating physician, physician assistant, podiatrist or nurse practitioner. See Workers’ Compensation physical therapy.
  • Medicare: No referral is needed to start, but your physician, nurse practitioner or physician assistant must certify your plan of care. See physical therapy with Medicare.
  • Some commercial plans and HMOs: Your plan may require a referral or prior authorization before it pays.

When to see a doctor first

Physical therapy does not replace a medical diagnosis. Call your doctor or get urgent care before booking with us if you have:

  • loss of control over urine or stool
  • numbness or weakness in your buttocks, thigh, leg or pelvis
  • pain that started after a severe fall or blow
  • an unexplained fever along with back pain
  • a history of cancer, or weight loss you cannot explain
  • pain that is worse when you lie down or that wakes you at night
  • trouble walking or keeping your balance

For chest pain or trouble breathing, call 911. If your evaluation turns up anything that needs a physician’s attention, we will tell you and refer you.

Your first physical therapy appointment, step by step

  1. Schedule. Call (716) 332-4838 or request an appointment online.
  2. Paperwork. Arrive 30 minutes early to fill out forms, or ask us to email you a digital intake link so you can complete them online before your visit.
  3. Evaluation. Your physical therapist talks with you about your symptoms, history and goals, then examines how you move. For back, neck and many joint problems, that includes a McKenzie (MDT) assessment of how your symptoms respond to repeated movements and positions.
  4. A plan you understand. Your therapist explains what the exam found, sets goals with you and shows you what to do at home. If treatment starts that same day, it counts as your first direct access visit.

What to bring

  • Your prescription or referral, if you have one
  • Your insurance card
  • A list of your current medications
  • Copies of any MRI, CT or X-ray results, or operative reports

For a car accident or work injury, bring your claim information too.

What to wear

Choose comfortable clothing you can move in and that lets your therapist see the area: shorts for leg problems, a sleeveless shirt for shoulder or elbow problems.

If you need to cancel

Please call as early as possible if you need to cancel or reschedule. Our hours are Monday 8:30 AM to 6:30 PM; Tuesday to Thursday 7 AM to 6:30 PM; Friday 7 AM to 4 PM; closed Saturday and Sunday.

Finding the clinic

We are at 531 Virginia Street, Suite 1, Buffalo, NY 14202, between Allentown and the Buffalo Niagara Medical Campus. The Allen/Medical Campus Metro Rail station is about a 4-minute walk away, and there is street parking nearby. Get directions and parking details.

Ready when you are: call (716) 332-4838 or request your first appointment. With most plans, no referral is needed to get started.

Sources

Questions

Common questions

Not sure about a referral, your coverage or your first visit? Call us and we will walk you through it.

Call (716) 332-4838
Do I need a referral for PT in NY?

For most plans, no. A qualified physical therapist in New York can treat you without a referral for 10 visits or 30 days, whichever comes first. You do need a referral for No-Fault and Workers' Compensation claims, Medicare needs your provider to certify your plan of care, and some insurers require a referral before they will pay.

Can I just make an appointment with a physical therapist?

Yes. Call (716) 332-4838 or request an appointment online, and have your insurance card ready. It is still worth asking your insurer whether your plan needs a referral to pay for physical therapy.

Can you go to PT without a diagnosis?

Yes. New York law lets a physical therapist evaluate you without a referral, and your therapist will explain what the exam shows. A physical therapy evaluation is not a medical diagnosis, though, so if anything points to a problem outside physical therapy, you will be referred to a physician.

What happens after 10 visits or 30 days?

To keep treating you, your physical therapist needs a referral from a physician, nurse practitioner, physician assistant, podiatrist, dentist or licensed midwife. The 30 days start with your first treatment and include weekends and holidays. You can ask your primary care provider for the referral.

What should I wear to physical therapy?

Wear comfortable clothes that let your therapist see and move the area being treated. Shorts work well for hip, knee or ankle problems, and a sleeveless shirt helps with shoulder or elbow problems.

Virginia Street, Buffalo

Start physical therapy this week

With most plans, you can begin without a referral under New York's direct access law. Call us or request a time, and we will confirm your coverage before your first visit.

Request an appointmentCall (716) 332-4838

Mon to Fri, open as early as 7 AM