Insurance Denied Physical Therapy: What To Do

Insurance denials for a physical therapy often involve session limits, medical necessity review, prior authorization, or missing documentation showing why therapy is needed. The most important first step is to read the denial letter carefully and identify the specific reason the insurer gave.

Helpful documents may include physical therapy notes, physician recommendations, diagnosis information, and records of progress or ongoing impairment. If the denial letter says information was missing, include the missing information with the appeal whenever possible.

A clear appeal letter should identify the patient, insurer, member ID, claim number, denied physical therapy, denial reason, and request for reconsideration. It should explain that the treating provider recommended the care and list the records attached for review.

Keep the tone factual and professional. The goal is to make it easy for the insurer to understand what was denied, why you disagree, and what documents support another review.

ClaimFighter includes a therapy denial category. You can upload the denial letter, confirm extracted details, select the category, and generate an editable appeal draft that you can review and download.