Digital physical therapy practice and payment during the COVID-19 pandemic: A case series.

BACKGROUND: Insurance regulation and reimbursement are barriers to physical therapy-delivered digital practice. OBJECTIVE: The present case series describes the clinical reasoning, outcomes, and practical use of digital tools to improve pain and movement of patients seen for musculoskeletal pain during the COVID-19 pandemic. CASE DESCRIPTION: Three patients, 2 with low back pain and 1 with cervicogenic headache, were treated at a private outpatient clinic. Collaborative reasoning was used to determine appropriate use of digital tools. Because of the pandemic, one patient used telephone visits to complete treatment (25% of total visits), one used telehealth visits only during stay-at-home orders (33% of total visits), and one was evaluated and treated entirely using telehealth (100% of total visits). All visits were billed and paid for by the patient or insurance at the same rate as an in-person visit. OUTCOMES: All 3 patients met self-reported goals for physical therapy, met or surpassed their risk-adjusted predicted functional status score, and expressed high satisfaction with treatment. CONCLUSION: Individualized prescription and execution of digital physical therapy practice allowed patients with musculoskeletal pain to have effective physical therapy care during the COVID-19 pandemic. Removal of regulatory and payment barriers were necessary for the provision of care.