Frequently Asked Questions

Should I come early to fill out paperwork?

Please arrive 15 minutes early for your appointment. It is important to remember to bring your prescription and insurance card(s).

What should I bring to my first appointment?

Please bring your Doctor’s prescription for physical therapy along with your insurance card(s) and a photo ID . If you should have any reports for a surgery or diagnostic images, please bring those as well.

How long is my appointment?

Each appointment is one (1) hour in length and is spent entirely with your physical therapist. Aides and assistants are not involved in your care.

What can I expect to happen on my first visit?

On your first visit your physical therapist will perform a thorough evaluation of posture, strength, range of motion and a functional biomechanical analysis of the involved region. You will be working together to develop a comprehensive treatment program to address your needs.

What should I wear?

Please wear comfortable clothing (shorts or workout pants, and a tank top or t-shirt) that allows the therapist access to your injured/hurt area. For women with shoulder and neck issues, wearing a tank top or camisole will allow therapist better access to your area of concern.

Do you have a changing room?

Yes, we have several rooms for you to change your clothes before and after your visit. We also offer shower facilities and a place to store your personal items during your session.

 

 

Do you take my insurance?

When you call to make your first appointment, we will request your insurance information to confirm your benefits and determine if you will have a co-insurance payment due at each visit. Agile Physical Therapy is Medicare certified.

How does Agile calculate the portion of patient responsibility paid up front?

The patient is responsible for all costs not covered by their health plan for their out-of-network physical therapy visits, up to our rate of $250 for an evaluation and $240 for follow up visits, plus modalities.  Before you come in for your first appt, we contact your insurance company to determine your out-of-network co-insurance coverage and how much of your out-of-network deductible you have met. The patient is responsible for all costs up to their out-of-network deductible.  Once your out-of-network deductible has been satisfied, the patient responsibility is estimated based on the patient’s out-of-network co-insurance coverage through the patient’s health plan. Please note that every health plan has different reasonable and customary rates, which make it difficult for us to accurately predict your exact costs.

For Example: If you have met your out-of-network deductible for the year, and your insurance covers 50% for your out-of-network physical therapy costs, then we estimate that your portion of the visits would be $125 for a physical therapy evaluation and $120 for each follow up visit. If you have not met your deductible, then you would pay the full cost of the visit until you meet your out-of-network deductible and then your insurance would cover at the out-of-network coinsurance percentage.

Do I pay at the time of my visit?

Yes, we kindly request you pay your co-insurance at the time of your visit. If you forget your wallet, don’t worry, we can take care of it next time.

How long will it take for Agile to know exactly how much I owe?

Our goal is to have all our billing submitted to your insurance within 7 days of your visit. From there, it is in the hands of your insurance company. On average, we see insurance companies process claims within thirty (30) to forty-five (45) days.

What billing codes do you use for physical therapy?

Physical therapy charge codes we most commonly submit include:

Physical therapy evaluation: 97161, 97162, 97163,

Manual therapy: 97140

Therapeutic exercise: 97110

What is the most physical therapy could cost?

Our base rate for a physical therapy visit is $250 for the initial visit and $240 for each follow-up visit.  At times, your physical therapist may determine that you would benefit from use of additional modalities, such as vasopneumatic compression, ultrasound, electrical stimulation, heat, and/or ice, to name a few.   Any additional services that are delivered will be discussed between you and your therapist first.  Please refer to our rate form to see the nominal fees associated with these modalities.

Can’t you bill my insurance more so they will pay more?

The amount paid by your health plan is based on that health plan’s reasonable and customary rate, or allowed amount.  This amount is often different than the amount we bill to your insurance company.  The amount allowed by your insurance company is based on the services rendered and the geographic region of the provider.  The allowed amount for each procedural code is not dependent on the amount billed by Agile.   We are required to submit charges to all health plans based on our set fee schedule.

Why should I come to Agile?

Agile is one of the few clinics in the Bay Area that offers individualized, patient-centered care.  All of our team therapists are amongst the best in the profession. Following a comprehensive evaluation, your therapist will work with you to develop a unique treatment plan tailored to your specific condition.   While our rates may be higher,  the individualized, focused care approach we believe in at Agile often results in far superior outcomes in fewer visits than other clinics.   

  • Outstanding patient outcomes: We are in the top 10% nationally when we compare the amount of improvement we see in a patient’s function per visit compared to other clinics across the country.
  • Exceptional patient experiences: Since 2002, 96% of our patients would recommend us to a friend or family member.
  • Individualized, focused care approach: We offer one hour long appointments for all of our evaluations AND follow up visits. This allows you and your PT to thoroughly address your concerns. You won’t have aides or assistants taking over your care, and you won’t have pre-programmed therapy.
  • Quality care valued: Our costs reflect the time, expertise, and energy we devote to you and improving your quality of life.
Where are you located?

Our main office is located at 3825 El Camino Real in Palo Alto.

We also have a satellite location at the Rancho Shopping Center in Los Altos. See our Directions/Maps page for more information.

Do you have a back/neck/shoulder/knee specialist?

All of our therapists are trained to treat a variety of conditions. Our office staff can help you determine the best therapist for you to work with based on your injury, sport, or schedule.   Please visit our staff page for further information on each of our therapists.

Do I need a prescription?

You do not need a doctor’s prescription to see a physical therapist in California. You can be treated by a physical therapist for 12 sessions or 45 calendar days, whichever occurs first. Beyond this period, you are able to continue with physical therapy only after having received an in person examination and approval of your physical therapist’s plan of care by a physician, osteopath or podiatrist, certified in the state of California.
Some health insurance companies still do require a physicians referral in order to cover physical therapy services. We will help you determine if you insurance company requires a physical therapy prescription prior to your first visit.

What is the cancellation policy?

We would appreciate 48 hours notice if you need to cancel so that we may open your appointment time to other patients.  If you cancel with less than 48 hours notice, we will charge you $120 the first missed appointment, and $240 for any missed appointments thereafter.