For many people, physiotherapy can provide a dramatic improvement in quality of life. Physical therapists work with patients suffering from a wide variety of medical conditions, from back pain and spinal cord injuries to pelvic floor dysfunction.

When researching physiotherapy, Canadians often wonder how much they can expect to pay and whether they are eligible for publicly-funded services. Here is what you should know about the benefits of physiotherapy and its costs in Canada.

Who Can Benefit from Physiotherapy?

A physical therapist is a trained, licensed medical professional who specializes in diagnosing abnormalities in physical function and working with patients to restore, maintain, and promote proper physical activity. Depending on the patient’s condition, physical therapy can help prevent surgery or aid in post-surgery recovery.

It offers benefits to patients with a broad range of health conditions, including:

• Back and neck pain
• Sports injuries
• Muscular Dystrophy
• Osteoporosis
• Carpal Tunnel Syndrome
• Limited Range of Motion (ROM)
• Chronic Fatigue Syndrome
• Pelvic Floor Dysfunction

Physical therapists work in varied healthcare settings, including hospitals, nursing homes, private clinics, outpatient offices, rehab centers, and more.

Physiotherapy: Standard Procedure

Most physiotherapy patients undergo a standard treatment protocol of:

1.  Assessment. Typically, the assessment includes reviewing the patient’s medical history and performing relevant tests for range of motion and flexibility.
2.  Diagnosis. After ascertaining the patient’s condition, the physical therapist will suggest an individually tailored treatment plan.
3. Treatment. Treatment usually involves a personalized exercise program and often joint manipulation or massage, as well. Additionally, the physical therapist may recommend lifestyle changes.

The number of sessions a patient requires will depend on their specific condition. Most relevant medical conditions require 6-12 visits to a physical therapist.

What to Expect During the First Visit to a Physiotherapy Clinic

During the patient’s assessment visit, the physical therapist may ask some of the following questions:

• Can you locate and evaluate the pain? Where does it hurt, and how painful is it on a scale of 0 to 10?
• Would you characterize your discomfort as burning, heaviness, tingling, or something else?
• When does the pain get worse (in the morning, while trying to sleep, during physical exertion)?
• How long have you been experiencing the symptoms?

After a detailed assessment and usually some physical tests, the physical therapist will work together with the patient to set a treatment plan. They will offer the patient a realistic prognosis of how treatment can help them regain or maintain function.

Types of Physiotherapy

Many physical therapists choose to specialize in certain conditions (like sports injuries) or ages (elderly or children, for example). Broadly speaking, you may encounter physical therapists who focus on:

Sports Physiotherapy

This type of physiotherapy concentrates on helping athletes recover from sports-related injuries. The treatment course often includes stretching exercises, massages, and ergonomic adjustments.

Sports physiotherapy can become more expensive. It may require special equipment such as resistance bands and fitness balls the patient may need for in-home exercises. However, some physiotherapy clinics offer discounts on exercise equipment.

Orthopedic Physiotherapy

Orthopedic physiotherapy is perhaps the most common type of physical therapy. It targets individuals suffering from back and neck pain due to a range of musculoskeletal conditions. Often the patients are recovering from surgery or an accident. This type of physical therapy may involve exercises, electrical stimulation, and hydrotherapy.

The main element that can bring up the cost of orthopedic physiotherapy is the number of sessions the patient requires. After a major surgery or catastrophic accident, many people need physiotherapy on a long-term basis.

Pediatric Physical Therapy

A pediatric physical therapist usually concentrates on helping children improve their gross motor skills. This type of physical therapy is often beneficial in conditions such as muscle diseases, congenital disabilities, and spina bifida.

Frequently, exercises focus on helping the child attain the maximum level of function in settings such as school or other community environments. Pediatric physical therapy engages young patients with age-appropriate, fun activities to help boost their motivation.

Geriatric Physical Therapy

Geriatric physical therapy focuses on helping seniors improve their quality of life in the face of common age-related conditions such as arthritis, stroke, or incontinence. Treatment plans frequently encompass targeted exercises, massage, manual therapy, and chiropractic adjustments.

Geriatric physiotherapy can get expensive because seniors often suffer from complex and multiple health conditions, each of which may require targeted therapy. Sessions can cost as much as $200. If the patient requires in-home physiotherapy treatment, the cost of a single session may jump up to $500.

Palliative Physiotherapy

Physiotherapy often forms an important part of palliative care in patients suffering from progressive life-limiting conditions, including cancer, multiple sclerosis, and motor neuron disease. It can help with pain management, improve quality of life, and assist patients in extending their ability to function for as long as possible.

Palliative physiotherapy can take place in the patient’s home or a hospice setting.

Physiotherapy Costs

Physiotherapy costs in Canada may vary depending on the type of medical condition, the PT’s areas of expertise, and the specific clinic. Typical price ranges are as follows:

• One-hour physical therapy session: between $95 and $125, including administrative work
• A 15-minute service unit: about $25
• An initial assessment session: usually between $75 and $100, but the price may climb up if the assessment is long or complex
• Massage: $60 for a one-hour session
• Manual electrical stimulation: $200 to $500 per hour

Costs also vary between different provinces and cities. A treatment plan that costs $500 in Toronto may cost between $150 and $300 in Alberta. This price gap may prompt patients to undergo treatment in more affordable locations if the price difference is higher than travel and accommodation costs.

How to Choose a Reputable Physical Therapist

Choosing a trustworthy and professional physical therapist doesn’t have to feel like a gamble, but don’t assume that the most expensive physiotherapy clinic will provide the best results. Instead, pay attention to:

• Whether the provider is a professional who has received proper training and is licensed to practice in Canada
• The physical therapist’s experience and specialties
• How the PT encourages questions and fosters a team effort

Check out the physical therapist’s reputation, too: do they have positive local reviews from satisfied clients? Word-of-mouth referrals are usually the most trustworthy.

Health Insurance and Physical Therapy

Many workers’ insurance plans cover a certain percentage of physiotherapy costs. However, not all employers choose to include physio benefits in their workers’ insurance coverage, and not every individual has private coverage.

People may face a problem if they unexpectedly require physical therapy services but don’t have coverage and can’t afford to pay for physical therapy out of pocket. In these cases, the person may qualify for government-funded physiotherapy.

Who is eligible for publicly funded physiotherapy services?

Although specifics vary between provinces, publicly-funded physiotherapy may allow Canadian residents to receive physiotherapy services free of charge if they:

• Have an appropriate medical reference from a licensed physician or nurse practitioner
• Are older than 65 or younger than 19
• Were recently hospitalized and require physiotherapy services due to the injury, illness, or medical condition that had led to the hospitalization
• Are eligible for benefits under a program such as Family Works or Disability Support

For example, OHIP (Ontario Health Insurance Plan) covers physiotherapy services for individuals who recently experienced an injury, accident, or surgery. The number of therapy sessions OHIP covers will depend on the physiotherapist’s assessment, the patient’s treatment plan, and the treatment progress.

Episode of Care

Canadians who qualify for a publicly funded physiotherapy plan will receive coverage according to the episode of care model. This approach allows the eligible individual to benefit from coverage for an entire course of treatment without a pre-set number of sessions.

Typically, there is a coverage cap for a single episode of care, but the OHIP plan allows an individual to apply for multiple episodes, for example, if he or she needs physiotherapy to treat several conditions.

It is important to note that not all physiotherapy clinics participate in OHIP (and similar plans in other provinces), which may limit the patient’s choice of physical therapists.

Who is not eligible

Government-funded physiotherapy won’t provide coverage for individuals who:

• Aim to preserve an existing level of physical ability or function
• Need long-term rehabilitation
• Require specialized services
• Have physiotherapy coverage through the WSIB (Workplace Safety Insurance Board), auto insurance, or any government healthcare program

For example, if a 40-year-old individual without appropriate insurance coverage is interested in physical therapy to prevent chronic back pain from getting worse, he or she may have no option but to pay the full cost of physiotherapy out of pocket.

Many Canadians assume that their provincial healthcare plan fully covers physiotherapy costs, only to face an unpleasant surprise when they need physical therapy. Specifically, they may discover that their case doesn’t comply with eligibility terms or that coverage only reimburses them for a small portion of the treatment costs.

Employee Benefits: Physiotherapy Coverage

Group health insurance plans for employees often provide some coverage for physiotherapy costs. Physiotherapy counts as paramedical coverage, along with speech therapy, massage therapy, and chiropractic treatment.

Employee benefits always limit physiotherapy coverage to a certain annual cap, usually in the range of $350 to $750 per year. Sometimes, there is a coverage cap per visit, and the employee must pay the difference. In many cases, group insurance plans don’t require a physician’s referral to physiotherapy.

Extended Healthcare Benefits for Reduced Physiotherapy Costs

In many cases, government plans and standard group insurance plans don’t cover physiotherapy costs or provide insufficient coverage. At Group Enroll, we can help you find insurance plans offering physiotherapy coverage beyond what a standard policy would provide.

We specialize in helping businesses find quick, comprehensive, simple, and affordable extended health care benefits group insurance. Fill out our quick quote form and start comparing plans today. You can also email us at [email protected].