Telehealth physical therapy
Telehealth physical therapy has become a standard part of care delivery in recent years — but before the COVID-19 pandemic, it was rarely used.
What began as a necessary shift to protect patients and providers while maintaining continuity of care has since transformed into a widely accepted and effective treatment model.
Over the past five years, telehealth PT services have changed how physical therapists deliver care and how patients access it, offering greater flexibility, safety, and accessibility.
Summary
- Telehealth physical therapy, once rare before COVID-19, is now proven effective, with research showing outcomes equivalent to in-person care and even better adherence for some conditions.
- Key benefits include expanding a therapist’s client base beyond geographic limits, personalized home-based care, improved access for vulnerable populations, and reduced overhead without sacrificing quality. Sign up for our free course on starting a teletherapy practice.
- Hybrid care models balance the convenience of telehealth with the need for occasional in-person treatment, especially when hands-on techniques are required.
- Starting a telehealth practice requires HIPAA-compliant software, awareness of evolving insurance rules adapted outcome measures, and updated marketing strategies.
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Many physical therapists pivoted to providing virtual physical therapy appointments when clinics shut down and vulnerable clients felt unsafe coming to appointments in person.
Emergency updates to insurance coverage policies and legislation allowed for these changes. Still, as Americans have settled into a more stable existence alongside the COVID-19 virus, the future of telehealth remains uncertain.
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While it is unclear how reimbursement and allowance of telehealth physical therapy will continue, there is no doubt that many patients and providers have been reaping the benefits of this flexible form of patient-provider interaction.
In this article, we will discuss many of the benefits of starting a telehealth physical therapy practice as well as some important things to take into consideration when doing so.
Is telehealth physical therapy effective?
The big question on therapists' minds at the beginning of the pandemic, when a sudden shift to telehealth services was observed, was undoubtedly, "Does this approach even work?"
At the time, therapists had few resources to guide their telerehabilitation practice. However, since then, much research and published literature have emerged to assess the effectiveness of this approach and help therapists practice it effectively.
In 2024, the American Physical Therapy Association (APTA) published a Clinical Practice Guideline on Telerehabilitation for physical therapy.
This CPG synthesized recommendations from 45 separate articles and serves to help PTs and PTAs implement best practices in telerehabilitation.
They found that based on available research, there is moderate-quality and strength evidence to recommend telerehabilitation or hybrid care services to our patients as "they are at least equivalent to in-person physical therapy with respect to patient acceptability and satisfaction and are superior to in-person physical therapy with respect to adherence and attendance for certain health conditions."
Now that we know that telehealth services can be just as effective as in-person treatment when applied optimally, let's explore some of the benefits of telerehabilitation.
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Four key benefits of telehealth physical therapy
For those of you still considering whether telehealth physical therapy is right for your practice, let's discuss some of its benefits for both clients and PTs.
1. Ability to expand client base beyond your zip code
Before the availability of telehealth physical therapy services, clients were limited to the providers in their geographic area. For the high number of clients who live in suburban or rural areas, their choices of care can be quite limited.
Telehealth physical therapy services provide clients with access to therapists who are experts in their field, no matter where they are in their state. It also helps providers expand their reach beyond a geographically based service area.
2. Personalized home-based care
Telehealth physical therapy allows therapists to create interventions and a home exercise program that are tailored specifically to a patient's home environment. It also provides an opportunity to involve other family members or caregivers in virtual physical therapy.
This personalization can increase the likelihood of adherence to a home exercise program and the success of treatment.
3. Health, safety, and access for vulnerable populations
The COVID-19 pandemic made us all more aware of the risks that many immunocompromised individuals face when they enter the community. Fears of getting sick can be a serious barrier to receiving the physical therapy one needs.
The option to complete your telehealth physical therapy within the safety of your home can help solve this issue.
Telerehabilitation visits also help patients overcome social and structural barriers, such as difficulty leaving the house, lack of transportation, and need for childcare, ensuring more people receive the vital care they need.
4. Reduced overhead without sacrificing care
Therapists never want to sacrifice the quality of patient care to save money. Telehealth physical therapy provides an inherent way to lower costs without sacrificing patient care.
With physical therapy telehealth services, the need for costly equipment and clinic space is significantly diminished. This can keep costs down, which in turn can improve accessibility of care and encourage more amazing therapists to start their practices.
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Evidence for a hybrid approach
Skeptics of telehealth for physical therapy often point out the inability to apply hands-on assessment and treatment techniques during a telehealth visit. No doubt observing and guiding someone via computer or phone screen hinders a therapist's ability to use one of their most excellent tools.
In cases where manual treatment or assessment is deemed essential for the patient's progress and plan of care, considering a hybrid treatment approach can solve this problem.
In a hybrid model, patients split their time between in-clinic and virtual appointments.
A study examining the effectiveness of pelvic floor physical therapy via a telehealth model published in 2024 in the Neurogastroenterology and Motility Journal (Karhu, et al 2024) found that "utilizing telehealth in conjunction with in-person visits by skilled pelvic health physical therapists for addressing [pelvic floor dysfunction] appears to be the preferred route of therapy for [the] majority of patients.
[A] Hybrid model may increase access to care effectively while meeting patient demand for the convenience of remote treatment options."
Now that telehealth is more of an option than a necessity for most clients, be sure to consider which patients may benefit from in-clinic, fully remote, or hybrid approaches to their care.
What you need to launch a telehealth physical therapy practice
Starting a telehealth physical therapy practice requires several steps to ensure compliance with privacy laws, insurance provider rules, and to set up an effective system for providing high-quality care. Here are some tips to get you started with telehealth physical therapy.
Choose HIPAA-compliant software
Using a HIPAA-compliant video-conferencing software is an essential step to ensure your clients' data and privacy are maintained. In addition to using the right software, consider the individuals present around you and the patient to ensure their confidentiality during your virtual physical therapy session.
Understand insurance rules (Medicare, Medicaid, Private)
As of October 2025, providers will no longer be reimbursed for telehealth visits delivered to Medicare beneficiaries in their homes and pre-pandemic rural and facility restrictions would return.
If you contract with Medicare, Medicaid, federal, state, or commercial insurance, you need to read their policies carefully. Look out for which CPT codes are covered for physical therapy telehealth services and any other special rules or regulations that have been updated or need to be adhered to.
For Medicaid and private insurers, coverage varies by state and plan, so some may still reimburse telehealth physical therapy—but you need to check each payer’s specific policies carefully.
If you’re a provider or patient relying on telehealth physical therapy, it’s essential to verify coverage with your insurance, especially post-October 2025.
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Adapt outcome measurement tools for virtual use
Because of the nature of telehealth physical therapy, you will no longer be able to manually assess strength, range of motion, tissue mobility, and so forth. While this may pose a challenge initially, with some careful preparation, you will be ready with functional and subjective outcome measures that you can administer during your evaluation.
This information allows you to track patient outcomes and substantiate the medical necessity of your virtual physical therapy treatment. Pay attention to psychometric properties to help you select well-validated outcome measures.
Rethink your marketing strategy
Physical therapy telehealth frees you from some geographical restrictions. Instead of being limited to clients within a reasonable circumference from your location, you can suddenly offer your telehealth physical therapy services to clients all over your state.
Not only does this increase your patient caseload, but it also provides an opportunity to target a specific patient population you may be interested in treating by increasing their access to your services.
To take advantage of this, you will need to update your marketing practices to target your new clientele.
As you can see, with careful preparation, telerehabilitation can offer many benefits. There are many more resources available now to help you deliver this type of care optimally, and for many of your patients, you will be making a significant impact in their care by doing so.
Streamline your practice with One EHR
- Scheduling
- Flexible notes
- Template library
- Billing & payments
- Insurance claims
- Client portal
- Telehealth
- E-fax
Resources
TheraPlatform is an all-in-one EHR, practice management, and teletherapy software built for therapists to help them save time on admin tasks. It offers a 30-day risk-free trial with no credit card required and supports different industries and sizes of practices, including physical therapists in group and solo practices.
More resources
- Therapy resources and worksheets
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- The Ultimate Insurance Billing Guide for Therapists
- The Ultimate Guide to Starting a Private Therapy Practice
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- Insurance billing 101
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- Free mini video lessons to enhance your private practice
- 9 Admin tasks to automate in your private practice
References
Karhu E, Gurland B, Barten J, Miller L, Yi G, Shen S, Neshatian L. Telehealth is effective for pelvic health physical therapy. Neurogastroenterol Motil. 2024 Aug;36(8):e14844. doi: 10.1111/nmo.14844. Epub 2024 June 14. PMID: 38873829.
Lee AC, Deutsch JE, Holdsworth L, Kaplan SL, Kosakowski H, Latz R, McNeary LL, O'Neil J, Ronzio O, Sanders K, Sigmund-Gaines M, Wiley M, Russell T. Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline From the American Physical Therapy Association. Phys Ther. 2024 May 1;104(5):pzae045. doi: 10.1093/ptj/pzae045. Erratum in: Phys Ther. 2024 Jun 4;104(6):pzae077. doi: 10.1093/ptj/pzae077. PMID: 38513257; PMCID: PMC11140266.
