Insurance & Accepted Plans
We accept Medicare, Medicaid, No-Fault, Workers' Compensation, and major commercial plans at all six Queens & Long Island locations. Benefits verified before every first visit.
Benefits Verified Before the First Visit. No Surprises - for Your Patient or for You.
Every patient referred to Dynamic Physical Therapy has their insurance benefits fully verified before their first appointment. We confirm coverage, the number of authorised visits, applicable co-pay and deductible amounts, any prior authorisation requirements, and whether a physician prescription is required for their specific plan and payer.
Your patient arrives for their first appointment knowing exactly what their out-of-pocket responsibility is. We do not leave patients to discover coverage limitations after the fact. For No-Fault and Workers' Compensation cases, we manage all carrier authorisation and documentation - your patient does not need to navigate the payer relationship independently.
Every Plan Category We Accept - and How Each Works
Click any plan category below to see coverage details, what we handle, and what your patient or their attorney needs to know.
What Is Covered
What We Handle
What Is Covered
What We Handle
PT Coverage Under Medicare Part B
Medicare Advantage Plans
Coverage Details
What We Verify at Intake
Plans We Accept
How In-Clinic Diagnostic Studies Are Billed
Diagnostic studies performed at Dynamic PT - EMG/NCS, evoked potentials, musculoskeletal ultrasound, and VNG - are billed separately from physical therapy services under their own CPT procedure codes. This distinction is important for prescribing physicians: a PT prescription does not automatically authorise diagnostic testing, and some plans require separate prior authorisation for diagnostic procedures.
We clarify this at intake for every patient - confirming which diagnostic services are covered under their specific plan, what the patient's cost-sharing responsibility is for each modality, and whether any prior authorisation or separate physician order is needed before proceeding.
EMG & Nerve Conduction Studies
Billed under electrodiagnostic CPT codes (95860 - 95913 range). Covered by Medicare Part B, Medicaid, No-Fault, Workers' Comp, and most commercial plans when medically indicated. Typically requires a physician order specifying the clinical indication.
Evoked Potentials (SSEP / VEP / BAER)
Billed under evoked potential CPT codes (95925 - 95930 range). Covered by Medicare, No-Fault, Workers' Comp, and most commercial plans when clinically indicated. Particularly well-covered under No-Fault for MVA neurological injury documentation.
Musculoskeletal Ultrasound (MSKUS)
Billed under diagnostic ultrasound CPT codes (76881 - 76882 range). Covered by Medicare Part B, No-Fault, Workers' Comp, and most commercial plans as a diagnostic imaging study. Coverage varies by plan - confirmed at intake.
Videonystagmography (VNG)
Billed under vestibular function testing CPT codes (92540 - 92546 range). Covered by Medicare, No-Fault, Workers' Comp, and most commercial plans for evaluation of dizziness and balance disorders. No-Fault coverage is routine for post-traumatic vestibular complaints.
When a Prescription Is Required - and What to Write
The prescription requirement for physical therapy and diagnostic testing varies by payer. Here is a practical guide to what each scenario requires from the referring physician.
No Prescription Required to Begin PT
Patients may self-refer and begin physical therapy evaluation and treatment
Prescription Typically Required for Coverage
Most plans require a physician prescription for PT billing - and always for diagnostic studies
Prescription Required - Carrier Handles Authorisation
All No-Fault PT and diagnostic services require a physician prescription and carrier authorisation
Common Insurance Questions
My patient has No-Fault insurance following an MVA. Do I need to write a prescription for both PT and the diagnostic studies?
Yes - No-Fault carriers require a physician prescription for each service category separately. A prescription for physical therapy does not automatically authorise EMG/NCS, evoked potentials, MSKUS, or VNG. For each diagnostic study you want performed, the prescription or order should specify the study and include the clinical indication - for example, "EMG/NCS bilateral upper extremities - cervical radiculopathy post-MVA" or "VNG - post-traumatic dizziness and vertigo." We submit the No-Fault authorisation (NF-3) for each service to the carrier and manage the approval process. If a carrier denies a study, we respond with clinical documentation and manage the appeals process - you do not need to handle carrier disputes.
Does Medicare cover in-clinic EMG/NCS and musculoskeletal ultrasound at a physical therapy practice?
Yes - EMG/NCS and diagnostic musculoskeletal ultrasound are covered under Medicare Part B when medically indicated, and can be performed and billed by appropriately credentialed physical therapy practices. The key requirement is medical necessity - the clinical indication must be documented and the study must address a specific diagnostic question that is relevant to the patient's care. We confirm Medicare coverage for each diagnostic modality at intake, including the patient's specific Medicare Advantage plan if applicable, since Medicare Advantage coverage can differ from traditional Part B. A physician order specifying the clinical indication is required for all diagnostic studies, regardless of Medicare plan type.
What happens if a patient's No-Fault benefits are exhausted or the carrier denies continued treatment?
If a No-Fault carrier denies continued treatment through a peer review or IME-based denial, we respond with comprehensive clinical documentation supporting the medical necessity of continued care. We handle the denial response and appeals process - your patient does not navigate this alone. If the denial is sustained and No-Fault benefits are exhausted, we discuss alternative payment options with the patient - including whether their health insurance, a letter of protection through their attorney, or self-pay arrangements are available. We do not abruptly terminate care when a carrier denies a claim; we work through the denial process and advise the patient of their options before any change to their care.
My patient is a union member with a 1199 SEIU or other union health plan. Do you accept these?
Yes - we accept 1199 SEIU and other union health plans. Union health plans typically function like commercial insurance plans with their own benefit schedules, network requirements, and prior authorisation processes. Coverage details - including whether our locations are in-network for the patient's specific union plan, the applicable co-pay, and any prior authorisation or prescription requirements - are confirmed during our benefit verification process before the first appointment. If you are unsure whether a specific union plan is accepted, have your patient call us directly at (718) 826-3200 and we will verify their benefits before scheduling.
Can a patient self-pay if they prefer not to use insurance?
Yes. Patients who prefer to pay out-of-pocket - whether because they want to preserve their No-Fault benefits, avoid using their health insurance deductible, or simply prefer a self-pay arrangement - may do so. Self-pay rates for PT and diagnostic services are discussed transparently during the intake process, and patients receive an itemised estimate before proceeding. For No-Fault cases specifically, some patients choose self-pay for certain services while using No-Fault for others, depending on their specific situation - we advise on the most practical arrangement based on their insurance circumstances.
Not Sure If a Patient's Plan Is Accepted?
Call us. Our intake team verifies coverage in real time and can confirm acceptance for any plan before you write the prescription.