Maintenance Physical Therapy

Have you or a family member ever been discharged from physical therapy and told that you had to be released from physical therapy because “you no longer qualified” or “you have plateaued in your progress?” Have you then thought “I’m not ready to be discharged from my physical therapy yet?!” You may still qualify to continue with physical therapy through our maintenance physical therapy program!

Maintenance physical therapy is designed to assist you in maintaining your current functional status or prevent a decline in mobility. Maintenance physical therapy was first introduced in 2013 when insurance providers began paying for physical therapy for patients who were not expected to improve and who previously would not have qualified. This opened the door to begin providing and/or continuing to provide physical therapy to patients who had certain complex medical conditions like neuromuscular diseases. The traditional model of restorative physical therapy has a specific requirement that you must be able to improve in function to qualify for service, but there are certain diseases and conditions that no matter how much therapy you provide, they will not improve. This is where maintenance physical therapy fits in and can help.

Maintenance physical therapy can help you maintain your current functional mobility. Maintenance physical therapy is not traditional restorative therapy and often misunderstood. Many physical therapists, home therapy service providers, and outpatient therapy clinics choose to not offer these services or at best underutilize these services.

Physical therapists CAN work with you even when no improvement is expected, when no improvement is made, and when the need for physical therapy is simply to prevent deterioration. We understand the benefits of maintenance physical therapy and are here to serve you.

Genuicare Therapy Services

Basics of Maintenance Physical Therapy:

  • Improvement is not expected and does not determine your eligibility.
  • The goal is to maintain your current level of function and/or prevent a decline in mobility.
  • Insurance coverage is based on an individualized assessment and need.
  • It is covered when the needed therapeutic interventions constitute a high level of complexity.
  • There must be a chronic and degenerative condition that is complex in nature, i.e. neuromuscular disorders
  • There must be specific needs for the skilled physical therapy program.
  • It is covered to establish a maintenance program – to initiate, instruct, and educate you, family, or any non-skilled caregiver on how to complete the program.
  • If you are unable to carry out the program safely by yourself, you are required to designate a family member or have a non-skilled caregiver present during maintenance therapy visits to be instructed and educated.
  • Maintenance physical therapy is not restorative physical therapy.
  • You can transition from receiving restorative physical therapy to maintenance therapy.
  • Insurance will cover periodic reevaluations.
  • Insurance will cover visits to follow-up and reinforce instruction/training and to determine program efficacy and/or the need for modification.
  • Routine exercise and walking programs are NOT reimbursed. They will be part of the established maintenance program but NOT the intent of physical therapy visits.

Expectations of Maintenance Physical Therapy

  • Maintenance physical therapy will be covered by Medicare and some insurance providers.
  • There will be an initial evaluation to assess condition, impairments, and complexity.
  • The physical therapist will design a maintenance program for you to carry out.
  • Visit times will be approximately 45 – 60 minute sessions including the discussion of your condition, assessment of functional status, and instruction and education on the maintenance program or revisions to the maintenance program.
  • You will be required to carry out the program by yourself, with a family member, or with a non-skilled caregiver.
  • If you are unable to carry out the program safely by yourself, you will be required to have a family member or non-skilled caregiver present during therapy visits to be instructed and educated.
  • Therapy visits will not be covered in situations where there simply isn’t a competent or skilled caregiver available to perform the maintenance program.
  • Typically, there will be a higher frequency of visits when starting the program in order to educate, instruct, and reinforce how to properly carry out the maintenance program.
  • The frequency of therapy visits will be based on the clinical judgment of the physical therapist and your unique clinical condition.
  • The frequency of visits will always be less than a restorative physical therapy program.
  • You and/or your caregivers will be periodically reviewed and re-instructed to ensure that you are properly carrying out the maintenance program.
Health & Wellness vs Maintenance PT

Since 2008, Genuicare’s mission has been to improve the overall health and wellbeing of our aging population so they can live the most active and abundant life possible. We will forever be committed to that.
Our motto is “A Genuine Care that Never Quits.”

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