Hand therapy is a specialized form of occupational therapy focused on the hand, wrist, elbow, and shoulder. It supports recovery from injury, surgery, or chronic conditions that affect how people move, work, and live.

Treatment may include therapeutic exercises to restore range of motion and strength, hands-on techniques to address stiffness or tightness, custom splinting, wound care, and education to support a safe, confident return to everyday activities.

Becoming a Certified Hand Therapist (CHT) requires advanced training and years of focused clinical experience. This level of specialization is why many physicians and surgeons refer patients to CHTs to support optimal recovery.

To qualify for the certification exam, a therapist must:

• Be a licensed Occupational Therapist (OT) or Physical Therapist (PT)

• Have at least three years of clinical experience

• Complete at least 4,000 hours treating upper extremity conditions

• Pass a comprehensive national exam covering anatomy, surgery, rehabilitation, and clinical problem-solving

Certified Hand Therapists must also recertify every five years through continuing education and ongoing clinical practice to maintain current, evidence-based skills.

Bottom line: CHTs have specialized expertise to help you heal, restore function, and return to the activities that matter most to you.

In addition to her Certified Hand Therapist (CHT) credential, Sarah maintains several specialized certifications that support comprehensive, safe, and well-rounded care.

• Skin and Wound Management Certification (WCC), National Alliance of Wound Care and Ostomy (since 2016)

• CPR & AED Certification, American Heart Association (since 2010)

• 200-hour Vinyasa Yoga Teacher Certification (RYT), Yoga Alliance (since 2026)

Sarah’s experience practicing and teaching yoga has strengthened her ability to integrate mindfulness and holistic approaches into clinical care.

No. Hand to Shoulder Wellness operates as an out-of-network provider.

This model allows for high-quality, personalized care with longer treatment sessions and fewer restrictions than traditional insurance-based therapy. The focus stays on your goals and recovery, not on paperwork, visit limits, or authorizations.

Reimbursement Options

A detailed superbill can be provided after each session upon request for you to submit to your insurance for possible out-of-network reimbursement. Many plans offer out-of-network benefits, particularly after a deductible has been met. Coverage varies by plan, so it’s recommended you check your specific benefits before starting treatment.

Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) may also be used for payment.

Payment Options

Payment is due at the time of service. Accepted forms of payment include cash, check, major credit cards, and FSA/HSA cards.

Planning Multiple Sessions?

View discounted package options for additional savings on multiple visits.

Short answer: No.
Virginia is a direct access state for occupational therapy, which means you can begin treatment without a physician’s order.

The longer answer:
While a prescription isn’t required, having one can sometimes enhance your care. When medical providers collaborate, treatment tends to be safer, more coordinated, and more effective. If you’ve had a recent injury or surgery, a physician’s order can help support open communication between your hand therapist and doctor. In certain situations, a prescription may be recommended.

For insurance purposes:
If you plan to submit a superbill for possible out-of-network reimbursement, having a physician’s order may also improve your chances of coverage. Insurance policies vary, so it’s best to confirm your specific requirements before starting treatment.

Yes! Sarah enjoys working with children and teens. She has a natural ability to make therapy feel approachable, engaging, and developmentally appropriate. Sessions often incorporate play-based activities, clear explanations, and creative elements to help younger clients feel comfortable and actively involved in their care.

For younger children: A caregiver is asked to stay for the full session to support home practice and reinforce skills between visits.

Think comfortable and accessible. Clothing should allow easy access to the area being treated, as Sarah may also assess nearby muscles and joints to provide the most effective care.

• Shoulder or elbow concerns: Sleeveless or loose-fitting tops work best

• Hand or wrist concerns: Short sleeves or clothing that rolls up easily is ideal

When in doubt, prioritize comfort and mobility.

At this time, Sarah is licensed to provide occupational therapy services only in Virginia, in accordance with state licensing laws.

Coming soon:
Virginia has joined the Occupational Therapy Licensure Compact, which will allow occupational therapists to practice across participating states once the compact is fully implemented. With Virginia finishing it’s required steps sometime this year, Sarah expects to be able to treat clients located in any participating state soon!

You can view the current list of participating states on the OT Compact Map.

Payment installments may be available for select package programs and are considered on a case-by-case basis at the discretion of Hand to Shoulder Wellness.

All installment arrangements must be discussed and agreed upon in advance. Installments are not available for single sessions or non-package services.