Is Physiotherapy Covered by OHIP in Ontario? 2024
verified information
Information verified by Adeline Harmant
Our articles are written by experts in their fields (finance, trading, insurance etc.) whose signatures you will see at the beginning and at the end of each article. They are also systematically reviewed and corrected before each publication, and updated regularly.
Discover the methodologyIf you're wondering whether physiotherapy is covered by OHIP, you're not alone. Many Ontarians seek physiotherapy for recovery from injuries, surgeries, or chronic conditions, but the question of coverage can be confusing.
In Ontario, OHIP offers physiotherapy coverage for eligible patients, including seniors and those recently hospitalized. However, not everyone qualifies, and the specifics of what OHIP covers and how to access it vary.
In this guide, we’ll answer your top questions about OHIP physiotherapy coverage on eligibility, services covered, and how private health insurance can help, so you can understand your options and get the treatment you need.
OHIP Physiotherapy Coverage: Key Points
- OHIP covers physiotherapy for eligible seniors and patients.
- Doctor referral required for OHIP-covered physiotherapy services.
- OHIP covers physiotherapy after surgeries or recent hospital stays.
- Not all physiotherapy clinics accept OHIP coverage—choose approved providers.
- Private insurance can cover additional physiotherapy not funded by OHIP.
Does OHIP cover physiotherapy?
Yes, OHIP covers physiotherapy. The Ontario Health Insurance Plan (OHIP) funds physiotherapy treatment through the Ontario Community Physiotherapy Clinic Program. Treatment is entirely covered by OHIP, which means it’s always free to the patient.
A doctor or nurse must first refer you to the program. A physiotherapist will then determine whether or not you are eligible through an assessment and diagnosis of your condition. Finally, you will get a treatment plan.
Your physiotherapy sessions will end when you’ve achieved your treatment plan’s goals or when you can reach that goal on your own.
Good to know
Being referred to the program by a healthcare practitioner does not automatically mean you are eligible for OHIP-covered physiotherapy. Only OHIP physiotherapy clinics can confirm if have access to the government program.
If you want to know all the services covered by OHIP, take a look at our complete guide on OHIP coverage in 2024.
What physiotherapy is covered by OHIP?
OHIP covers physiotherapy in two broad situations:
- A recent illness, injury, accident or surgery that has resulted in decreased function or movement
- A flare-up or worsening of symptoms from a previous illness, injury, accident or chronic condition that has led to reduced function or movement
Expert advice
Before going to a physiotherapy clinic covered by OHIP near you, you must first be referred by a doctor or nurse, so your first step should be to see your main healthcare provider. This is true for any case.
People who suffer from a chronic condition, like arthritis, osteoporosis or Parkinson's disease, might also be eligible for physiotherapy covered by OHIP, but there are considerable constraints.
OHIP will only fund physiotherapy that addresses worsened symptoms or acute episodes and only if the recent symptoms have impacted your mobility or ability to function in your daily life. Under OHIP coverage, physiotherapists are not allowed to provide additional care or services beyond what is required to treat the condition outlined in your prescription.
Due to the nature of the program, physiotherapy funded by OHIP is not for long-term rehabilitation or continued treatment of chronic disease. Instead, it focuses on periodic, goal-based episodes of care, so any sustained treatment is not covered.
If you don't qualify for physiotherapy coverage under OHIP or need specialized coverage, you can opt for a health insurance plan. Explore Canada's best health insurance plans right here using our free tool below. You can Compare coverage and get instant quotes online.
Compare The Best Health Insurance Plans in Ontario
What physiotherapy isn’t covered by OHIP?
OHIP does not cover physiotherapy if the objective of your treatment is:
- Maintainance of your current level of function or ability to move
- Mid or long-term rehabilitation
- Specialized treatment such as stroke or heart attack recovery
Watch out!
If you receive other physiotherapy services funded through any insurance or government-funded healthcare programs, you are not eligible for OHIP-funded physiotherapy.
Although long-term care is not covered by OHIP, you might still have access to some, or even full, funding.
Is pelvic floor physiotherapy covered by OHIP?
Pelvic floor physiotherapy is not typically covered by OHIP. This type of therapy is considered a specialized service and falls outside the scope of OHIP’s coverage, which is focused on essential medical treatments for specific conditions like recovery from surgery or injury.
The cost for pelvic floor physiotherapy can vary depending on the clinic and location but generally ranges between $75 to $150 per session. Since multiple sessions may be needed for effective treatment, the total cost can add up.
What does physiotherapy cost without insurance or OHIP coverage?
Without insurance, the cost of physiotherapy in Canada can vary based on location and clinic. On average, a single physiotherapy session can cost between $75 and $150. More complex treatments, assessments, or specialized services may increase the cost.
Here's a table with the average physiotherapy costs for the most common services in Ontario.
| Physiotherapy Treatment | Average Cost (Without Insurance) |
|---|---|
| Initial Physiotherapy Assessment | $80 - $130 |
| Follow-Up Physiotherapy Session | $60 - $100 |
| Pelvic Floor Physiotherapy | $100 - $150 per session |
| Shockwave Therapy | $85 - $150 per session |
| Acupuncture (with Physiotherapy) | $70 - $120 per session |
| Sports Injury Rehabilitation | $75 - $120 per session |
| Manual Therapy | $70 - $110 per session |
Private health insurance can be beneficial in covering part or all of these expenses. Many private plans offer extended health benefits that include physiotherapy, which can help reduce the out-of-pocket cost for pelvic floor therapy. If you need this coverage, you can explore the best health insurance plans right here using our free tool below. Get instant quotes in seconds.
Compare The Best Health Insurance Plans in Ontario
How do I get my physiotherapy covered by OHIP?
The first thing you’ll need to get OHIP-covered physiotherapy is an OHIP health card. You are required to show your OHIP card every time you see a doctor, visit an emergency room or have a medical test or surgery. It proves that you have coverage and is requested by participating doctors and healthcare providers throughout Ontario.
The next step is securing a prescription, or referral, for physiotherapy covered by OHIP. You can get one from your doctor or nurse practitioner.
Watch out!
Be cautious when choosing your OHIP physiotherapy clinic as each referral can only be used at a single clinic.
Am I eligible for OHIP physiotherapy coverage? You’ll also need to fit into one of the following four categories:
- Be 65 years old or older
- Be 19 years old or younger
- Have recently been admitted to a hospital for an overnight stay for an injury or condition that could benefit from physiotherapy — no age limits
- Be approved for Ontario Works (OW) or Ontario Disability Support (ODSP) — no age limits
Good to know
If you have access to OHIP through OW or ODSP, you do not need an OHIP health card.
Remember that OHIP only covers recent illnesses, conditions, injuries or sporadic flare-ups that reduce mobility or make you unable to perform your daily life.
The final step to getting OHIP-funded physiotherapy is selecting a clinic. Not all clinics can provide services covered by governmental insurance. OHIP physiotherapy clinics are private healthcare providers that have a partnership with the government of Ontario for physiotherapy.
The clinic must then provide you with enough treatment to address your prescription; in other words, when you’ve achieved the goals of your treatment or when you can reach that goal on your own.
How much does OHIP cover for physiotherapy?
OHIP physiotherapy works through Episodes of Care (EOC). An EOC is the physiotherapy treatment necessary to address a specific condition or group of symptoms. Every EOC is time-limited and goal-oriented. Each EOC covered by OHIP requires a separate prescription.
According to the OHIP physiotherapy fee schedule, for each EOC, the physiotherapy clinic receives a lump sum of $312. With that amount, the clinic must provide all the treatment required to handle the reason for the EOC, including supplies and equipment.
Watch out!
No other OHIP funding is available to clinics. Unfortunately, with such a limited budget, OHIP clinics are often forced to provide group treatment, shorten appointments and rely on self-directed movements, which ultimately affects the quality of the treatment.
Although there is no limit to the number of EOCs a single patient can receive in a year, it is unlikely that you get more than one, unless your second EOC is entirely unrelated to the first.
When does OHIP stop covering physiotherapy?
Because OHIP-funded physiotherapy is goal-oriented and specific to loss of mobility, every Episode of Care (EOC) will inevitably end sooner rather than later. Your EOC ends when any one of the following criteria is met:
- Your physiotherapist deems your rehabilitation goals have been accomplished for this EOC.
- You can achieve the therapy goals on your own through self-directed exercise or classes such as fall prevention.
- Your physiotherapist determines that you will unlikely improve any further as a result of more physiotherapy.
Good to know
Since OHIP pays clinics for overall treatment (instead of per session), OHIP physiotherapy clinics push to end your treatment quickly, to keep your treatment as cost-effective and profitable as possible. As the payment for an EOC is usually lower than the average market rate, clinics are not economically encouraged to extend your treatment or provide anything above basic therapy or quick fixes.
If you still require physiotherapy after your EOC, you may already be eligible through your employer's insurance plan or if you have access to extended benefits. The truth is that OHIP-covered physiotherapy is quite limited, and you might need private health insurance to truly improve your well-being.
If you want to enhance your physiotherapy coverage beyond OHIP, take a look at the best health insurance plans using our free tool below. Compare personalized quotes online.
Compare The Best Health Insurance Plans in Ontario
Does OHIP cover physiotherapy for seniors?
If you are 65 years old or older, you are probably eligible for physiotherapy covered by OHIP. Note, however, that your eligibility hinges on whether or not you have suffered a recent illness, injury, accident or surgery that has resulted in decreased function or movement.
Otherwise, you are also eligible if you experienced a flare-up or worsening of symptoms from a previous illness, injury, accident or chronic condition that has led to reduced function or movement.
Any other reasons for requiring physiotherapy, such as chronic illnesses, are not eligible for OHIP coverage.
Good to know
The treatment plan outlined by your OHIP physiotherapist will usually include specific goals that are reasonable and measurable, for example, walking to the grocery store again or climbing stairs. Keep this in mind when you first visit the physiotherapist.
Does OHIP cover physiotherapy after surgery?
Yes, if you recently had surgery that led to a decline in function or movement, you may be eligible for OHIP-funded physiotherapy.
As a standalone criterion, however, having had surgery is not enough to get you covered by OHIP. You’ll also need to be older than 64 or younger than 20, have been admitted to a hospital for an overnight stay in the last 12 months or benefit from the Ontario Works (OW) or Ontario Disability Support (ODSP).
If you do not fall under any of the categories above, your physiotherapy will not be covered by OHIP, even if you did recently have surgery.
The good news is that if you had surgery, you likely stayed in the hospital overnight, and if the physiotherapy you need is related to the surgery, then you are likely able to be covered by OHIP.
FAQs on OHIP Physiotherapy Coverage
Yes, OHIP covers physiotherapy for eligible patients, including seniors and those with specific conditions, when prescribed by a doctor. Coverage is available at designated OHIP-funded clinics across Ontario.
OHIP does not specify an exact number of sessions. Coverage depends on the patient’s progress and medical needs, as determined by the physiotherapist and physician.
Yes, OHIP covers outpatient physiotherapy at specific clinics for eligible patients. These clinics must be government-approved and offer services based on a doctor’s referral.
Yes, OHIP covers physiotherapy for seniors aged 65 and older. Eligible seniors can receive treatment at OHIP-approved clinics when prescribed by a doctor.
Physiotherapy is not universally free across Canada. Some provinces, like Ontario, provide coverage for eligible patients through public health plans like OHIP, but private payments are common.
To find OHIP-covered physiotherapy near you, search for government-funded clinics or ask your family doctor for a referral to an approved clinic that accepts OHIP. Additionally, you can visit the Ontario Ministry of Health website or use their online search tool to locate government-funded physiotherapy clinics
