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Guide · Car accidents · All states

Physical therapy after a car accident: who pays, and the review rules

Updated By the Counselworthy teamGeneral information, not legal advice

Short answer

In New Jersey, PIP usually pays for it.

  • The PIP rules list licensed physical therapists among the providers paid for medically necessary care, whoever caused the crash.
  • After the first 10 days, the insurer's review plan can require the therapist to ask first, and it answers within 3 business days.

Checked November 2, 2026.

Sources: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.6; N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g); N.J.A.C. 11:3-4.4(e); N.J.A.C. 11:3-4.7(a), (b), (c)(4). Every fact cites a source

Checker

How will your physical therapy be paid?

Pick the one that fits. It shows the rule that applies and what you can check yourself. It can't tell you whether you need physical therapy, how many visits you need, or what to do in your own case.

My own car insurance, in New JerseyYour own policy's PIP
What it is
PIP pays medically necessary treatment by a licensed physical therapist, whoever caused the crash.
Why it matters
Every standard New Jersey auto policy includes PIP, and its rules list physical therapists among the providers it pays.
The rule
Up to $250,000 unless a lower amount was chosen in writing. Bills between your deductible and $5,000 carry a 20% co-payment.
What you can check

Check your policy's declarations page for your PIP medical limit and deductible.

Source: N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g); N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.6; New Jersey Department of Banking and Insurance, Auto Insurance New Jersey Buyer's Guide
I chose health insurance to pay firstYour health insurance, then PIP
What it is
Your health insurance pays crash medical bills first. PIP pays what it doesn't cover, up to the PIP limit.
Why it matters
New Jersey lets a policyholder choose health insurance as the first payer.
The rule
The state's buyer's guide says Medicare and Medicaid can't be used for this option.
What you can check

Check your health plan's rules for physical therapy, like a referral or a visit limit.

Source: N.J.S.A. 39:6A-4.3(d); New Jersey Department of Banking and Insurance, Auto Insurance New Jersey Buyer's Guide
I was hit while on footYour household's PIP, or the state fund
What it is
A New Jersey policy's PIP covers the policyholder and household relatives hit by a car while on foot.
Why it matters
Other pedestrians may be eligible for PIP from the state's Unsatisfied Claim and Judgment Fund.
The rule
Policies on vehicles that aren't private cars, like trucks, buses and motorcycles, must carry PIP for pedestrians they hurt.
What you can check

Check whether anyone in your household has a New Jersey auto policy.

Source: N.J.S.A. 39:6A-4; N.J.S.A. 39:6-86.7; N.J.S.A. 17:28-1.3
The therapist says the insurer has to approve more visitsYour PIP insurer's review plan
What it is
After the first 10 days, the provider may have to ask the insurer first, at points the plan sets.
Why it matters
The state's care paths set the standard course of treatment, with decision points marked on them.
The rule
The insurer must review a request within 3 business days, and decide on medical necessity. Skipping a required request can add a co-payment of up to 50%.
What you can check

Ask the therapist's office whether the request went in, and when.

Source: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.4(e); N.J.A.C. 11:3-4.7(a), (b), (c)(4); N.J.A.C. 11:3-4.6
PIP said no, or stopped payingPIP dispute resolution
What it is
Either side can take a PIP dispute to dispute resolution, run by an organization the state designates.
Why it matters
An insurer that denies a PIP claim must do it in writing, with reasons.
The rule
Overdue PIP payments carry interest at the court rate for judgments.
What you can check

Keep the denial letter. The PIP denied guide says what happens next.

Source: N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b)
My PIP limit is low, or ran outThe person at fault, or your health insurance
What it is
Medical bills above the PIP limits can be recovered from the person at fault.
Why it matters
The PIP law doesn't limit recovering uncompensated economic loss, like medical bills, from the person at fault.
The rule
Even with a lower limit, PIP pays up to $250,000 for medically necessary treatment of permanent or significant brain injury, spinal cord injury or disfigurement.
What you can check

Check your PIP medical limit on the declarations page, and keep every bill.

Source: N.J.S.A. 39:6A-12; N.J.S.A. 39:6A-2(k); N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g)
Health insurance, outside New Jersey's PIPYour health plan
What it is
Every Marketplace health plan covers rehabilitative services and devices.
Why it matters
It's one of the essential health benefits, for people with injuries who need to gain or recover physical skills.
The rule
The specific services covered can vary with each state's requirements.
What you can check

Check your plan's documents for physical therapy visits, referrals and co-payments.

Source: HealthCare.gov, Find out what Marketplace health insurance plans cover

What a physical therapist does

Whether therapy fits your injury, and for how long, is a question for a doctor who has examined you.

The jobMovement and pain

Physical therapists help injured or ill people improve movement and manage pain, the U.S. Bureau of Labor Statistics says. They use exercises, stretching, hands-on therapy and equipment.

The trainingA doctoral degree and a state license

New physical therapists need a Doctor of Physical Therapy degree, and every state requires a license.

Source: U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Physical Therapists

NJWho pays for physical therapy in New Jersey

NJYour own PIP first

Whoever caused the crash, up to $250,000 unless a lower amount was chosen in writing.

Source: N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g)
NJPhysical therapists count

The PIP rules list licensed physical therapists and licensed physical therapy assistants among the providers whose treatment is paid as medical expenses.

Source: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.6
NJIt has to be medically necessary

Consistent with your clinically supported symptoms and diagnosis, and in line with standard treatment protocols, including the state's care paths.

Source: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.4(e); N.J.A.C. 11:3-4.7(a), (b), (c)(4)
NJYour deductible and co-payment

Bills between your PIP deductible and $5,000 carry a 20% co-payment.

Source: New Jersey Department of Banking and Insurance, Auto Insurance New Jersey Buyer's Guide; N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g)
NJOr health insurance first

If you chose it, your health insurance pays crash medical bills first, and PIP pays what it doesn't cover, up to the PIP limit.

Source: N.J.S.A. 39:6A-4.3(d); New Jersey Department of Banking and Insurance, Auto Insurance New Jersey Buyer's Guide

NJThe care paths and the insurer's review in New Jersey

New Jersey sets a standard course of treatment for the injuries its care paths cover, and points in it where the provider has to ask the insurer first.

  1. Not in the first 10 days, or for emergency careNo decision point or precertification requirement applies then, and the care paths don't apply to emergency care.Source: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.4(e); N.J.A.C. 11:3-4.7(a), (b), (c)(4); N.J.A.C. 11:3-4.6
  2. The care paths set the standard courseThey're the standard course of medically necessary treatment, tests included, for the injuries they identify. Treatment that varies from them is paid only when medical necessity warrants it.Source: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.6
  3. At a decision point, the provider asks firstDecision points are marked on the care paths. There, the insurer's approved review plan has the provider ask before more treatment or tests.Source: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.6; N.J.A.C. 11:3-4.4(e); N.J.A.C. 11:3-4.7(a), (b), (c)(4)
  4. The insurer answers within 3 business daysIts decision has to be based on medical necessity.Source: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.4(e); N.J.A.C. 11:3-4.7(a), (b), (c)(4)
  5. Skipping it costs extraIf the provider doesn't ask where required, care given until it does carries an extra co-payment of up to 50% of the eligible charge.Source: N.J.A.C. 11:3-4.2; N.J.A.C. 11:3-4.4(e); N.J.A.C. 11:3-4.7(a), (b), (c)(4)

NJWhat Jersey City's police reports show about injuries

Counselworthy analysis of NJDOT's crash tables for Jersey City. Each report has an injury box for every person hurt: the most serious injury police wrote, and where on the body it was.

  • 75%of people hurt in Jersey City crashes had pain as the most serious injury on the police report: 6,068 of 8,114.
  • 33%of people hurt in Jersey City crashes had their most serious injury in the back or neck, by the police report (of those with a place recorded): 2,480 of 7,524.

What police wrote on each crash report (form NJTR-1), 2019 to 2023, the newest years NJDOT has published in full. It isn't a finding of fault. Source: NJDOT crash tables, checked October 16, 2026.

See every crash on Jersey City's crash map

The report is what an officer wrote at the scene. Whether PIP pays for therapy turns on whether your treatment is medically necessary, not on the report.

Outside New Jersey's PIP: health insurance

Where no PIP pays, or after it runs out, health insurance may cover physical therapy.

Marketplace plans cover rehabilitation

Every Marketplace health plan covers rehabilitative services and devices, for people with injuries who need to gain or recover physical skills.

Source: HealthCare.gov, Find out what Marketplace health insurance plans cover
The details vary by state

The specific services covered in each benefit category can vary with your state's requirements, so check your plan's visit limits and referral rules.

Source: HealthCare.gov, Find out what Marketplace health insurance plans cover
NJBills past PIP, from the person at fault

In New Jersey, medical bills above the PIP limits can be recovered from the person at fault.

Source: N.J.S.A. 39:6A-12; N.J.S.A. 39:6A-2(k)

What you can sort out yourself

Getting physical therapy paid is mostly between you, your therapist and your insurer.

  • DoFind your PIP medical limit and deductible on your policy's declarations page.
  • DoAsk the therapist's office whether it sends the insurer's review requests, and keep copies of what comes back.
  • DoKeep every bill and every letter from the insurer.
  • Don'tDon't count on visits to prove a claim. Under the usual New Jersey policy, a permanent injury is proven by a doctor's certification based on objective clinical evidence.
  • Don'tDon't ignore a denial letter. It has to give reasons in writing, and either side can take the dispute further.
Often handled aloneTherapy under PIP

PIP pays whoever caused the crash, so a lawyer isn't needed to get therapy paid. If PIP stops paying, either side can take the dispute to dispute resolution.

Worth a free consultationA lasting injury

Unless a driver chose otherwise in writing, a New Jersey policy allows pain and suffering claims only after the injuries the law lists, such as a permanent injury. A lawyer's fee is capped at 33⅓% of the first $750,000 recovered.

Source: N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g); N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b); N.J.S.A. 39:6A-8(a); N.J.S.A. 39:6A-2(i); N.J.S.A. 39:6A-8.1(b); R. 1:21-7(c), (d)

Sources

General information, not legal advice. We don't know the facts of your claim. A lawyer can review them, and most injury lawyers offer a free consultation.

What to do next

Questions people ask

Does car insurance pay for physical therapy after an accident?

In New Jersey, your own PIP pays licensed physical therapists for medically necessary treatment, whoever caused the crash, after your deductible and co-payment. In other states, it depends on the coverage there, and on your health plan.

Do I need approval for physical therapy after a car accident in New Jersey?

Not in the first 10 days. After that, your insurer's decision point review plan can require the therapist to ask first at points it sets, and the insurer has 3 business days to answer.

What are New Jersey's care paths?

The state's standard course of medically necessary treatment, tests included, for the injuries they identify. Treatment that varies from them is paid only when medical necessity warrants it, and they don't apply to emergency care.

What if PIP stops paying for physical therapy?

An insurer that denies a PIP claim must do it in writing, with reasons. Either side can take the dispute to dispute resolution, run by an organization the state designates. Bills above the PIP limits can be recovered from the person at fault.

How long should physical therapy last after a car accident?

That depends on your injury, and it's a question for the doctor and therapist treating you. In New Jersey, PIP pays only while treatment is medically necessary, and the insurer's review plan sets points where the therapist asks before more visits.

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