What ICBC covers: key points.
Under ICBC Enhanced Care, anyone injured in a BC motor-vehicle crash is pre-approved for a defined number of treatment visits per health profession. Physiotherapy, registered massage therapy, chiropractic, kinesiology, and acupuncture each have their own separate allotment. Visit allotments are per discipline, not shared, so using physio sessions does not reduce your RMT count. The 12-week window runs from the date of the crash, not the date of your first visit, and direct billing means you pay nothing at the visit, because Medstar Sport Physio in North Vancouver bills ICBC directly for every covered session. Diagnostic imaging is handled through the BC public health system rather than ICBC directly.
What "pre-approved" means under Enhanced Care.
Since the Enhanced Care system launched in May 2021, ICBC has shifted away from fault-based recovery for treatment costs. The practical effect is that anyone hurt in a BC crash, regardless of fault, is pre-approved for an initial period of care from the listed professions. The relevant policy framework is published by ICBC at icbc.com/insurance/our-insurance-explained/enhanced-care.
Pre-approval is exactly what it sounds like. The visits are authorised in advance, so the clinic does not have to fight for permission before each session. Your role is to attend the visits and engage with the rehab.
Per-discipline allotments.
| Profession | Pre-approved sessions | Regulator | Typical scope |
|---|---|---|---|
| Physiotherapy | Up to 25 pre-approved | College of Physical Therapists of BC (CPTBC) | Initial assessment, treatment, exercise rehab, manual therapy, IMS. |
| Registered massage therapy | Up to 12 pre-approved | College of Massage Therapists of BC (CMTBC) | Soft-tissue treatment within RMT scope. |
| Chiropractic | Up to 25 pre-approved | College of Chiropractors of BC | Spinal assessment, adjustment, soft-tissue work within DC scope. |
| Kinesiology | Up to 12 pre-approved | BC Association of Kinesiologists (registered, self-regulated) | Exercise progression, return-to-work conditioning, gym-based rehab. |
| Acupuncture | Up to 12 pre-approved | College of Complementary Health Professionals of BC (CCHPBC) | Acupuncture by a registered TCM practitioner. Physio-delivered IMS is separate. |
| Counselling / psychology | Up to 12 per discipline | BC College of Social Workers / College of Psychologists of BC | Post-collision anxiety, sleep disruption, return-to-driving support. |
Allotments are per ICBC's Enhanced Care policy and may change. We verify your specific coverage with ICBC before billing.
What direct billing means for you.
For pre-approved visits, you pay nothing on the day. The clinic bills ICBC directly. You sign a one-page consent at intake that allows the clinic to share clinical notes and treatment plans with ICBC, which is how they verify that visits are on track.
If a visit is going to fall outside the pre-approved allotment (for instance the 25th physiotherapy session is the last one in your window), we will tell you in advance. There are no surprise bills.
For the current self-funded session rate, see Medstar's Jane App booking page. Published rates live there and are kept current.
What ICBC does not cover.
- Treatment unrelated to the crash. Pre-existing conditions can sometimes be in scope if the crash made them worse, and your physiotherapist will document this carefully.
- Diagnostic imaging (X-ray, MRI): these go through MSP.
- Equipment beyond what is reasonable for early rehab. Most exercise tools you can use at home are not billed back.
- "Manual osteopathy." Osteopathy is not regulated in BC; ICBC funds the professions listed in the table above.
- Sessions after the 12-week window unless an extension is approved. See the extensions page.
ICBC coverage: common questions.
Are the visit numbers per profession, or shared across all of them?
Per profession. The physiotherapy allotment is separate from the registered massage therapy allotment, which is separate from chiropractic, kinesiology, acupuncture, and counselling. Using physiotherapy visits leaves your other counts untouched, so you can combine disciplines inside the same 12-week window. Physiotherapy and chiropractic are each pre-approved for up to 25 visits, and the other four are pre-approved for 12 each.
What does 'pre-approved' actually mean?+
It means ICBC has authorised the visits in advance, so nobody needs to request approval before each session and no doctor's referral is required. The clinic confirms your specific allotment with ICBC, then bills ICBC directly for each visit until the allotment is used or the 12-week window closes. That window runs from the date of the crash. For those visits you pay nothing at the clinic.
Does ICBC cover the cost of imaging like X-rays or MRI?+
Diagnostic imaging is handled through the BC public health system, the Medical Services Plan, which is where the cost sits. If imaging is clinically indicated after your assessment, your physiotherapist or GP refers you and you go through the standard public pathway. Imaging sits outside the pre-approved treatment allotments, so a referral for an X-ray uses none of your 25 physiotherapy visits.
What if I want to keep coming after the 25 physio sessions are used?+
You have two routes. ICBC has an extension pathway when there is documented ongoing impairment and a clear treatment plan, and your clinician prepares that request. If an extension is declined or your recovery is largely complete, you can move to care funded by an extended health plan or pay for visits yourself. Our page on what happens after the first 12 weeks walks through how that decision is usually made.
Does ICBC cover manual osteopathy?+
No. Manual osteopathy is not a regulated profession in British Columbia, and ICBC funds only the professions listed in its Enhanced Care coverage table: physiotherapy, registered massage therapy, chiropractic, kinesiology, acupuncture, and counselling or psychology. Some manual osteopaths also hold a registered massage therapy licence, and in that case they can bill within registered massage therapy scope. Ask any provider directly which licence they bill under.
Will I have to pay if I go over my pre-approved session count without knowing?+
No. If a visit is going to fall outside your pre-approved allotment, such as the 25th physiotherapy session being the last one in your 12-week window, the clinic tells you before that appointment happens. The same warning applies to a service ICBC does not fund at all. For pre-approved care we bill ICBC directly, you pay nothing at the visit, and no invoice arrives unannounced.
Can a pre-existing condition be covered if the crash made it worse?+
Sometimes, yes. Treatment unrelated to the crash generally falls outside ICBC coverage, and a pre-existing condition that the crash made worse can still be in scope. Your physiotherapist documents how the crash changed your baseline, noting what you could do before that you cannot do now, so ICBC can see what changed. Being open about your full history at the first assessment gives that record the detail ICBC needs.
Are diagnostic scans like X-rays or MRI covered by ICBC?+
Not billed to ICBC. Scans such as X-rays and MRI run through the BC public health system, the Medical Services Plan, on a referral from your physiotherapist or GP when the findings would change your treatment. Many soft-tissue injuries after a crash need no scan at all, because the assessment guides the plan. Your pre-approved treatment visits stay available either way, since imaging does not draw on them.
Got a claim number?
Send it over. We'll confirm coverage with ICBC and book you in this week.
Reviewed by Sanaz Davarian, PT, MSc, Owner & Director, Registered Physiotherapist, College of Physical Therapists of British Columbia (CPTBC). ICBC-authorized direct billing provider.
This page is for general information only and does not constitute medical or legal advice. ICBC coverage details, treatment allotments, and claim rules change, so confirm the current terms with ICBC or a legal adviser before relying on them. Treatment suitability is determined case-by-case during clinical assessment. Physiotherapy at Medstar Sport Physio & Health is provided by physiotherapists registered with the College of Physical Therapists of British Columbia (CPTBC).