If you have UPMC Health Plan insurance and you're dealing with back pain, a sports injury, or lingering pain after an accident, the good news is simple: yes, UPMC plans cover outpatient physical therapy — and Pittsburgh Physical Medicine is in-network with UPMC. Here's what that means for your wallet and your care.
What Being In-Network Means for You
Because our East Liberty clinic is in-network with UPMC Health Plan, your visits are billed at your plan's contracted rates — you pay your normal copay or coinsurance rather than out-of-network prices. No claim forms, no billing surprises: we submit everything directly to UPMC for you.
Do You Need a Referral First?
For most UPMC commercial plans, no PCP referral is required — UPMC members can generally self-direct their care to in-network providers, and Pennsylvania's direct access law lets you start PT without a physician's prescription for up to 30 days. That combination means you can usually call us today and be evaluated this week. (Two exceptions: auto accident and workers' compensation claims require a physician referral by state law — we'll help you arrange that. Read more in our Pennsylvania referral guide.)
What Will You Actually Pay?
UPMC offers dozens of plan designs, so your exact numbers live in your Schedule of Benefits, but here's the typical landscape:
- Copays for in-network PT visits commonly range from about $5 to $35 per visit depending on your plan tier. Some high-deductible plans use coinsurance after the deductible instead.
- Visit limits are common — many UPMC plans cover up to around 30 therapy visits per benefit period (sometimes combined between physical and occupational therapy). Most patients complete a full course of care well within that.
- Medical necessity applies: therapy must be treating a covered condition with documented progress, which is standard practice at any quality clinic.
The easy way: call us at (412) 404-8337 with your member ID and we'll verify your exact PT benefits with UPMC before your first visit — copay, deductible status, and remaining visits. It takes us a few minutes and costs you nothing.
UPMC Plan Types We See in the Clinic
- UPMC commercial plans (through your employer or the marketplace) — the most common; typically copay-based PT coverage as described above.
- UPMC for Life (Medicare Advantage) — covers PT with plan-specific copays; Medicare's plan-of-care certification rules apply, and we handle that paperwork.
- UPMC for You (Medical Assistance) — coverage rules differ; call us and we'll walk through your options honestly.
Why Patients Choose Us for PT in Pittsburgh
Physical therapy at Pittsburgh Physical Medicine is one-on-one with Dr. Charlie Crockatt, DPT — not a gym full of patients sharing one therapist's attention. And because chiropractic care, shockwave therapy, and medical massage are in the same office, your plan can combine approaches when that gets you better faster. We're at 5916 Penn Avenue in East Liberty, minutes from Shadyside, Bloomfield, Highland Park, and Lawrenceville, with free parking.
Questions? We're Happy to Help
At Pittsburgh Physical Medicine in East Liberty, our chiropractors, physical therapists, and massage therapists work under one roof, so you get the right care without bouncing between offices. Call us at (412) 404-8337 and our front desk will verify your benefits, answer your questions, and get you scheduled — or book online in about two minutes.
Note: This article is for general education and isn't medical, legal, or insurance advice. Coverage details vary by plan and can change — always verify your specific benefits with your insurer or let our team do it for you.