Direct access or not?

Mitchell Study: Cost-effectiveness of Direct Access to Physical Therapy

In a study conducted to determine whether direct access to physical therapy services provided by a licensed physical therapist is cost effective, it was found that:

• The total paid claims for physician referral episodes to physical therapists was 123% or 2.2 times higher than the paid claims for Direct Access episodes. The total paid claims averaged $2,236 for "physician referral" episodes as compared to $1,004 for Direct Access episodes. When expressed in terms of actual reimbursements, the difference in total paid claims per episode was $1,232.
• Physician referral episodes were 65% longer in duration than Direct Access episodes.
• Physician referral episodes generated 67% more physical therapy claims and 60% more office visits than Direct Access episodes.

Mitchell Study: A Comparison of Resource Use and Cost in Direct Access Versus Physician Referral Episodes of Physical Therapy (.pdf)

Jean Mitchell, PhD, Georgetown University, and

Gregory de Lissovoy, PhD, MPH, Johns Hopkins University, December 1994 

Last Updated: 1/13/2011

Contact: advocacy@apta.org