A physical therapy plan of care is the written treatment plan your physical therapist builds after your first evaluation. At a minimum it names the problem being treated, the long-term goals, the kinds of treatment you will receive, how often you will attend and for how many weeks or visits. In Indiana it is written by the licensed therapist who evaluates you, and if Medicare is paying, a physician or other qualified practitioner must also certify it.
Last reviewed By the Monon Therapy Collective editorial team
What has to be written into a plan of care?
Every plan of care records the diagnosis, the goals, the type of treatment, the number of sessions per week and the total length of the episode. Medicare lists those elements, plus the amount of treatment in a day, as the minimum for outpatient therapy, and most commercial insurers ask for the same information before they will keep paying for visits.
The plan is built from the evaluation, so it should read like a summary of what your therapist found and what they intend to do about it. A strong plan is specific: “walk the Monon Trail from Main Street to 116th Street and back without knee pain” is a goal you can check; “improve knee function” is not.
- Diagnosis: the condition or movement problem being treated, for example a medial meniscus irritation or post-operative stiffness.
- Long-term goals: what you should be able to do at discharge, written so that you and your therapist can both tell whether it happened.
- Type of care: physical therapy, plus the main interventions such as progressive strengthening, balance training or joint mobilization.
- Amount and frequency: sessions per day and per week, often stepped down as you become more independent.
- Duration: total weeks or total visits before the plan is reviewed.
Who writes the plan, and who has to sign it?
Your physical therapist writes the plan after examining you, and they sign and date it. Under Indiana’s direct access law you do not need a referral for the first 42 calendar days of treatment, so a physician signature is not required just to start, unless your insurer or Medicare asks for one.
Medicare adds a certification step. A physician or nonphysician practitioner, such as a nurse practitioner or physician assistant, must certify the therapist’s plan with a dated signature within 30 calendar days of the first treatment, and that certification covers the plan or 90 days, whichever is shorter. Since January 1, 2025, a signed and dated order or referral can stand in for that signature on the initial plan when the plan was sent to the practitioner within 30 calendar days of the evaluation. The referral rules in Indiana explain the 42-day window in more detail.
How are plan-of-care goals measured along the way?
Goals are measured with repeatable tests and with the activities you named at the start. Typical measures include range of motion in degrees, strength compared side to side, a timed sit-to-stand or walk test, a balance test, and a short questionnaire that scores how much your problem limits daily life.
Your therapist re-tests those measures at intervals and writes a progress note. Medicare expects a progress report at least once every 10 treatment days. Private plans set their own rules, and many tie further authorized visits to the numbers in those reports, which is one reason a vague plan can cost you visits later.
- Short-term goals: steps you should reach in two to four weeks, such as climbing one flight of stairs foot over foot.
- Long-term goals: the end point of the plan, such as returning to a weekly pickleball session or a full shift on your feet.
- Outcome scores: standardized questionnaires repeated so that change is visible, not guessed.
Can a plan of care change once treatment has started?
Yes, and a good one usually does. If you progress faster than expected, the therapist can reduce visits or bring the discharge date forward. If you stall, flare up or develop a second problem, the therapist revises the goals, the treatment or the timeline and documents why.
A significant change, such as treating a new body region or extending well past the original end date, may need a fresh signature from your physician under Medicare, and Medicare requires recertification at least every 90 days for a plan that continues. Commercial plans may ask for new authorization. If care is likely to run past 42 days without a referral on file, your therapist should raise it early. See how long physical therapy takes for typical ranges.
What should you ask when your therapist shows you the plan?
Ask to see the plan, ask what each goal means in daily life, and ask what would make the therapist change it. You are entitled to a copy of your own health records, and a plan you understand is far easier to follow between visits than one you have only heard described.
If you are in the Carmel area and starting from scratch, the matching team reads your two-minute questionnaire and proposes a therapist in the network whose focus and schedule fit. That therapist runs the evaluation and writes your plan; the matching team never does. Your first visit guide covers what to bring so the evaluation captures everything the plan needs.
- Which goal matters most to you, and is it written in words you recognize?
- How many visits per week, for how many weeks, and when is the first re-test?
- What should I do on days between visits, and how much?
- What would make you change the plan or send me back to my physician?
Related questions
Is a plan of care the same as a home exercise program?
No. The home exercise program is one part of the plan. The plan of care also covers the diagnosis, goals, visit frequency and length of treatment.
How long does a physical therapy plan of care usually last?
It depends on the problem. Many outpatient plans are written for a few weeks to a couple of months and then reviewed; plans after major surgery are often longer. Medicare certification lasts for the plan or 90 days, whichever is shorter.
Can I get a copy of my plan of care?
Yes. It is part of your health record, and you can ask the therapist’s office for a copy. Many therapists give you a summary at the end of the evaluation anyway.
Does the insurance company see my plan of care?
Often, yes. Insurers that require prior authorization or progress reviews ask for the plan and progress notes to decide how many visits they will cover.
What happens when all the goals are met?
You are discharged, usually with a written program to keep going on your own. Some people move on to supervised strength training at that point.
Keep reading
- How often should I go to physical therapy?
- How long does physical therapy take?
- Do I need a referral for physical therapy in Indiana?
- What is prior authorization for physical therapy?
- What happens at your first physical therapy visit
- Orthopedic physical therapy in Carmel
- How cost and insurance work for physical therapy
Sources
This page is general education, not medical advice. A physical therapist can only advise on your situation after an examination.
