Frequently Asked Questions

There is free parking in the rear of the building. While there are several ways to enter the lot, the easiest is to enter from Lincoln coming from the north, just after Wendy's. There are nine parking spots labeled PHYSICAL THERAPYWORKS at the southeast corner of the lot, i.e., on the left side when you enter the lot from Lincoln. For those of you interested in public transit, the 704 Metro Rapid Line stops right across the street, and if you'd rather take the train the Expo Line's final stop at 4th and Colorado is a short ten minute walk away. Finally, for the bicyclists, we installed a bike rack outside our rear entrance just for you!

There are two entrances into the clinic: FRONT ENTRANCE If you would like to use our Santa Monica Blvd entrance, please exit the parking lot and walk south to Santa Monica Blvd, then turn right and proceed to 719 Santa Monica Blvd. REAR ENTRANCE The other entrance is off the parking lot. If you exit your car and walk west, on your left you will see our "physical therapyworks" sign. To use this entrance you must descend several steps, so do not use this entrance if you have any concerns or difficulties with gait or balance.

Foremost, choose clothing that you are comfortable with. The more freely it allows you to move, the better. Also, it is helpful if clothing allows viewing and/or access to both the affected body parts as well as "regional contributors", e.g. we may want to also exam your abdominal area and spine if we're seeing you for a shoulder issue.

For your first visit, expect to be here for up to 90 minutes. Each subsequent visit will typically last somewhere between 40 and 75 minutes.

Please give us more than 24 hours notice for cancelations. If you cancel an appointment and give us less than 24 hours notice, or you fail to show to an appointment, you will be charged $75.00. For Monday appointments, in order to give us sufficient time to try to fill the canceled appointment, please contact us by the Friday prior by 1:00pm. To cancel, you may contact us by phone at 310-260-9039, and if you get voice-mail please leave us a message. All messages are date and time stamped. Or you may email us at info@physicaltherapyworks.com.

We don't take client satisfaction lightly. That's why we regularly solicit feedback from our patients and consistently strive to optimize our services and provide you with gold-standard care. Family. Welcoming. Warm. Attentive. Trust. Expert. Healing. Energy. Results. These are just a few of the ways our patients have described Physical Therapyworks. Our clients regularly express that they are highly satisfied with our services, and I want to make sure that you feel the same way. If at any time we are not meeting your needs or expectations, please reach out to me directly at john@physicaltherapyworks.com and let me know.

To learn more about how physical therapy insurance billing works, please click here.

The following, while long, is our best possible summation of a nine page long document which includes multiple hyperlinks. If you'd like to read the actual document please click here. 1. The Medicare Threshold refers to a policy that is triggered when a certain amount of money is paid in a year by Medicare for Physical Therapy. In 2024, that dollar amount is $2330.00. (If you’ve been to Speech Therapy the same year, the amount Medicare paid toward Speech Therapy is included in this amount). 2. The Threshold is a modification of what used to be called The Medicare Cap. The Threshold is different from the Cap, in that the Cap was a “Hard Limit”, i.e. Medicare wouldn’t pay for any additional PT once you reached the Cap, regardless of circumstances. 3. The Cap was replaced by the Threshold as a result of Physical Therapists banding together and successfully lobbying Medicare for the ability to continue care beyond the Cap. Our argument was, “What if a patient is just a few visits away from eliminating their functional limitations and achieving their functional goal(s), wouldn’t it make sense for us to see the patient a few more times and reach the goal(s)?” Remarkably, we were successful, and they replaced The Medicare Cap with the Medicare Threshold in 2018. 4. With the Threshold, Physical Therapists have the responsibility to determine whether or not continued care is justified once the Threshold dollar amount is reached, i.e. is the patient really just a few visits away from reaching their functional goal(s), and are we reasonably sure that a few more visits will allow the patient to reach their goal(s)? (A brief aside: This is different from how it works with private insurance companies, where an insurance company representative makes the decision based on the information that we provide them) If we determine that continued care is justified, we attach a “KX modifier” to the charges we send to Medicare from that point forward. The KX modifier indicates to Medicare that we have determined that ALL of the following is true and as a result continued care is justified: A) You continue to have one or more Functional Limitations. Functional Limitations are typically limits with the ability to perform activities of daily living, e.g. Bathe, dress, cook, clean, shop, drive or care for a dependent loved one. B) There are Impairments present that correlate with or are causative of your functional limitations, e.g. Weakness or Gait abnormalities, and there is strong evidence that demonstrates PT is effective in improving or correcting these impairments. C) Your impairments require Skilled Physical Therapy, i.e. they aren’t things you can do on your own and/or they aren’t things that we can teach a friend or loved one to do. D) Recent documentation demonstrates Measurable Progress trending toward eliminating the Functional Limitations, and we are confident that we’ll be able to continue to both document measurable/quantifiable progress and eliminate the Functional Limitations in a reasonable period of time (typically an additional 1 to 7 visits) 5. While we’re very pleased that the Threshold replaced the Cap, and we’re honored that Medicare put us in the role of decision maker to determine whether or not continued care is justified, this can result in quite a bit of stress. The typical reasons for the stress are: A) Patients think that there is not a Cap or Threshold. While it’s true that the Cap no longer exists, it’s been replaced by the Threshold. B) Patients think that the presence of pain justifies continued care. Unfortunately it does not. Medicare Treatment Guidelines (as described above in section 4) determine whether or not continued care is justified. C) Patients think that a Rx from their MD will allow continued care. While a Rx from an MD (or DPM) is one of the requirements necessary for coverage, a Rx for continued care does not override or supersede the Threshold. 6. Please know in advance that the vast majority of patients do not qualify for a Threshold exception, and please don’t anticipate being an exception to the rule. While we wish we could continue to see you, for whatever reason, without any limits, the truth is it is uncommon for a patient to qualify for a Threshold exception. Hopefully you'll reach your goals prior to reaching the Threshold, and you can bet we'll be doing everything we can to help you get there. 7. We are subject to audits for all patients, from the first visit onward, but once we declare a Threshold exception, the risk of an audit is significantly increased. If an audit is performed and it determines that a Threshold exception was not indicated, we have to pay the money back with interest. This can and does happen. In addition, one audit typically leads to additional audits. Medicare has the right to audit as many accounts as it likes and it can go back as far as seven years. 8. Lastly, for those of you that DO qualify for a Threshold exception please know that there is a second Threshold. This Threshold is at $3000.00 This Threshold is accompanied by a mandatory audit, i.e. the risk of an audit is 100%. 9. Please know that we went into this profession to be the best at arriving at PT diagnoses, the best at deciding what care to provide, the best at providing it, and the best at helping you reach your goals. Believe us, the majority of us did not get into PT to learn and adhere to administrative guidelines, document notes that related to said guidelines, or determine whether or not someone qualifies for Threshold exceptions. Alas, accepting these responsibilities comes with accepting Medicare as a form of payment. There isn’t a way around it and those that do ignore it face devastating consequences, including bankruptcy and closure. 10. If you don’t qualify for a Threshold exception but would like to continue to see us, you can sign an Advanced Beneficiary Notice (ABN) and pay for our services out of pocket. Lastly, there is one thing that can be good about limits: They can force us to focus, work harder, and make the best possible use of our time together. Please know that we’re doing our best from the minute we meet you until the minute we finish working together. Please join us in this spirit. We want nothing more than to help you reach your goals, and to do so we need your help. Please give it 100% so that together we can be successful., long before we hit the Threshold. You can bet we’ll be doing the same.

At Physical Therapyworks we are most definitely patient advocates, and helping patients get better to the greatest extent possible with the longest lasting results is not only the core of our mission, it is our mission. Doing this via insurance* means being aware of guidelines and limitations, however, and the insurance guidelines that are most often misunderstood are Medicare’s Treatment Guidelines. For that reason, we’ve decided to provide a synopsis of those guidelines. All of the following must be true to provide physical therapy services via Medicare, from the first visit and thereafter, in order to satisfy Medicare’s Treatment Guidelines: 1. Physical Therapy treatment is used for functional limitations. Typical examples include: The patient is unable or has difficulty bathing, dressing, cooking, eating, driving, shopping, or caring for a dependent loved one. 2. The Physical Therapist has found impairments that are the cause of or related to these functional limitations, and there is a scientific foundation that backs up the ability of the physical therapy interventions to positively affect these impairments. 3. Skilled Physical Therapy is required to correct these impairments. It is not something that can be performed independently by the patient, nor can it be taught to a loved one to be performed for the patient. 4. Measurable progress is being made toward the correction of the impairments, which in turn is correcting the functional limitation, and it is expected that both the impairments and limitations will be corrected in a reasonable period of time. Documentation of said progress is quantifiable, clear and occurs at regular/reasonable intervals. These guidelines are in fact long and complicated, and they’ve changed over the years as well. If you want or need a complete explanation of them, we’ve provided a link to the actual guidelines. Click here for the actual guidelines. *If you’d rather not be subject to these guidelines (as well as many other boundaries and limitations) you may consider seeing us via PTWorks+.

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Here at Physical Therapyworks, we are and have been taking the COVID-19 outbreak seriously and monitoring it closely. The health and safety of our patients, clients, and staff is our top priority. We have always taken pride in following CDC guidelines in providing a clean and healthy rehabilitation and fitness environment. We’re a Santa Monica Shines Assured business, which means going above and beyond regarding COVID-19 safety protocols to make sure you are as safe as possible when you visit. Since this outbreak our responsibility as healthcare providers has been to ramp up our cleaning protocols and frequency, upgrade our cleaning products to CDC approved COVID-19 cleaners, and ensure that all commonly touched surfaces throughout the clinic are cleaned regularly. All equipment and touched surfaces are subject to cleaning on a regular and frequent basis, and we have completed the Santa Monica Shines online training on COVID-19 awareness and customer service. All patients are queried as to whether or not they have a fever or cough, and whether they have been in contact with anyone that has the COVID-19 virus. Hand disinfectant/sanitizer is available at both clinic entrances. Mask wearing is optional for both patients and staff as per the most recent LA County Department of Health Guidelines. If you would like your provider to wear a mask, please say so, and they will be happy to do so. Social distancing is encouraged throughout the clinic, and private rooms are used as is appropriate. We encourage everyone that's part of our Physical Therapyworks family to stay healthy by following these best practices: -Wash your hands often with soap and water for at least 20 seconds, especially after visiting the restroom; before eating; after blowing your nose, coughing, sneezing or touching your face -Avoid touching your eyes, nose, and mouth with unwashed hands -Please stay home if you are feeling unwell -Cover your cough or sneeze with a tissue, then discard the tissue in the trash -Support your immune system with plenty of water, a healthy diet, adequate sleep, and exercise For more information on COVID-19 resources and news updates: U.S.: Centers for Disease Control and Prevention Canada: Public Health Agency of Canada If you are sick (even for mild illnesses), as much as we love you all, we are asking that you stay home and help keep others from getting sick. Please give us a call and we will gladly reschedule you! Your wellbeing is our top priority. Thank you all for your continued support. We know that if we work together we can get through this together.