Insurance and referrals
Do I need a referral for physical therapy in Maryland?
Maryland allows you to see a physical therapist for evaluation and treatment without a physician referral, with no visit limit. Some insurance plans still ask for one, and we check that for you.
The details
What to know
Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.
That is the state rule. The other factor is the insurance plan: PPO plans and TRICARE Select generally let patients book physical therapy directly, while HMO plans, TRICARE Prime, and some Medicaid managed care plans require a referral from the primary care provider even where the state does not. EMS Therapy checks both before the evaluation and tells the patient exactly what to ask for.
In Maryland, EMS Therapy is careFirst BlueCross BlueShield, Aetna and Medicare in-network; private pay for other plans. Visits are by video anywhere in the state, one-on-one with Dr. Elana Shalem, DPT, and the first step is a free 15-minute discovery call.
If a referral is needed, the most useful wording is "pelvic floor physical therapy, evaluate and treat" (or "physical therapy, evaluate and treat" for an orthopedic problem) with the diagnosis written on it. Referrals can be faxed to 844-886-0285.
How it works
How a virtual visit works
Most of pelvic floor physical therapy is education, breathing and pressure management, movement retraining, and a home program. All of it works on camera. During the evaluation, Dr. Shalem guides a self-assessment so she can see how the pelvic floor is coordinating with breath and movement. An internal examination is not possible by video; if a hands-on assessment would change the plan, she says so and helps the patient find local care.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
- A phone, tablet, or laptop with a camera
- A private room
- A mat or towel
- About an hour
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Maryland.
Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
More about Dr. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.