| The unfortunate individuals having to deal with | | | | PT. Make sure you, as the recipient of health care, do |
| adhesive capsulitis (also known as frozen shoulder) | | | | your due diligence towards what your individual policy |
| many times end up choosing frozen shoulder physical | | | | may cover regarding therapy. |
| therapy as their treatment choice. If the person has | | | | Individuals injuring there shoulder on the job may be |
| decent insurance this is a wise choice, however since | | | | covered by Workmans compensation. All employers |
| this condition knows no economic boundaries, many | | | | with greater than 5 employees are required by law to |
| times the sufferer has less than adequate insurance | | | | carry Workmans compensation insurance. This does |
| and is faced with the possibility that their particular | | | | not necessarily mean treatment for your injury is |
| policy will not cover such services. | | | | covered. The resulting injury and development of |
| Traditionally in the past Medicare has always covered | | | | adhesive capsulitis must be documented as work |
| physical therapy services provided they are medically | | | | related. Therefore all work related accidents or injuries |
| necessary. However there has been an ongoing battle | | | | must be reported to a supervisor who documents the |
| in congress on whether to cap physical therapy | | | | dates and times of the occurrence as the first step. It |
| services after a certain amount has been paid. A cap | | | | is also a good idea to keep your own log of dates and |
| is very limiting as it usually encompasses other ancillary | | | | times, mileage, etc... if you are injured during the course |
| services. This means that if someone has extensive | | | | of performing work duties. |
| medical problems they may have very little if any | | | | Medicaid recipients will need to check with their |
| therapy covered by the time they need it. Frozen | | | | provider to see if Medicaid is accepted. If it is, then |
| shoulder physical therapy in particular requires multiple | | | | consult with the therapist directly as to how many units |
| sessions with one-on-one joint mobilization in order to | | | | or allowable charges his or her plan of care may |
| achieve functional range of motion. | | | | require. Medicaid restricts certain charges to a finite |
| Recipients of Blue Cross Blue Shield insurance typically | | | | number per year. |
| have been covered at the rate of 80/20 - that is 80% | | | | All-in-all, frozen shoulder physical therapy is covered by |
| insurance responsible and 20% patient responsible. | | | | most insurance plans in some form or fashion, but |
| However it is becoming more frequent to see some | | | | each individual will need to due a little investigation to |
| BCBS policies limiting outpatient therapy to a number | | | | make sure they are covered and do not end up with |
| of visits per year. Good luck if you have a particularly | | | | out-of-pocket expenses. |
| bad year with more than one injury or surgery requiring | | | | |