Access and Coverage for Physiotherapy FAQ’s

ACCESS & COVERAGE FOR PHYSIOTHERAPY – FAQ’S from the Physiotherapy Association of BC (www.bcphysio.org)

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Do I need a doctor's referral to see a physiotherapist?

No. Physiotherapists are university trained medical professionals and primary care practitioners. This means that you have direct access to physiotherapy without a doctor’s referral.

In some circumstances, such as publicly funded community physiotherapy clinics, or certain extended health plans, a doctor or nurse practitioner referral is required to access funding. Consult your insurance provider to learn whether a referral is needed in your specific case prior to commencing treatment.

I was injured at work, am I covered by WorkSafeBC?

For all work-related injuries, WorkSafeBC will pay for your initial visit as long as your claim is registered with WorkSafeBC and you have a claim number. Further physiotherapy treatment may be covered after your claim is approved. A referral from your doctor is not necessary. You must ensure that you seek treatment from a physiotherapist who has a contract with WorkSafeBC to treat Injured Workers. On approved claims, there is no fee for service.

After an injury you must:

  1. Report your injury to your employer.
  2. Seek medical attention for your injury as soon as possible. Be sure to tell your doctor that your injury is work-related.
  3. Report your injury to WorkSafeBC as soon as possible:
    1. If you miss any time from work, you must notify the Teleclaim Contact Centre (1-888-WORKERS).
      1. You may be asked by a representative to complete a Worker’s Incident and Injury Report
      2. or an application for Compensation and Report of Injury or Occupational Disease Form 6.
    2. If asked to do so, it is important that you do so and submit it as soon as possible.
  4. Book your initial physiotherapy appointment, and notify the physiotherapy clinic that your injury is work related.
I was injured in a motor vehicle accident (MVA), am I covered by ICBC?

You are entitled to accident benefits whether you are at fault or not. There is no need for an initial doctor’s referral if the accident is recent and/or you have not had any previous treatment.   In most cases, you’re entitled to physiotherapy treatment, and your adjustor will let you know what will be covered.  For more information visit the ICBC website.

A portion of the physiotherapy fee will usually be billed to ICBC by the clinic, using the Teleplan electronic billing system. A supplemental clinic user fee is typically charged to you when receiving treatment post-MVA. This fee is your responsibility. The fee is determined by the therapist or clinic.  Ask your adjustor when and if you will be reimbursed for the fees.

If you have coverage through ICBC, you may begin physiotherapy treatment immediately after you report your claim to ICBC. Visit the ICBC website to learn how. The physiotherapist does not need to check with ICBC for prior approval – up to the established limit of 20 visits. Provide your physiotherapist with your ICBC claim number, your adjustor’s name, and phone number of your adjustor to begin treatment.

Can I Pay With MSP (Medical Services Plan) Premium Assistance?

If you are neither visiting a physiotherapist for an injury or condition that is work-related nor motor vehicle accident-related, you may have the option to pay by MSP (Medical Services Plan) Premium Assistance.

According to the BC Ministry of Health, over 1.2 million British Columbians receive MSP premium assistance of between 20 and 100 per cent of their premiums. Over 800,000 pay no premiums at all, with 37 per cent of BC seniors receiving some kind of premium assistance in 2012**.

For MSP beneficiaries receiving premium assistance, MSP will contribute $23 per visit for a combined annual limit of 10 visits each calendar year towards: physiotherapy, chiropractic, massage therapy, naturopathy, acupuncture, and non-surgical podiatry*.

The clinic you attend will be able to check your Care Card and confirm in advance whether you qualify as an MSP beneficiary. A user fee may be charged to the patient and is the responsibility of the patient. Fees are determined by the clinic.

Questions about eligibility, extra charges or reimbursement for insured services should be directed to Health Insurance BC.