Over the last several weeks I have received a number of inquiries pertaining to cash-based physical therapy, given that our clinic functions under this payment model. For those that have asked, and for others that may be curious, let me clarify what this payment system is and what it means for you.
In the most simplistic terms, a cash-based practice is one in which the clinicians do not accept insurance payments, accepting only direct payments from the patient, client or customer. This can occur through fees per visit, fees per package, or through monthly membership or subscription plans. Payment methods may include cash, checks, debit/credit cards, health savings accounts, or flexible spending accounts. Payment is due at the time of service, and is always at a stated price (at least it is here).
So you’re probably thinking, “but I have insurance, why wouldn’t I just go to a clinic that accepts my insurance?”
Let me further explain.
Most health insurance policies don’t cover the entire cost of physical therapy. Many patients are still responsible for copays and deductibles, so regardless, you will likely pay a fair amount out of pocket for physical therapy services. In fact, many in-network physical therapy clinics are charging $250/visit to your insurance company. If you haven’t met your deductible yet, not only are you responsible for your copay, but you would be responsible for the full cost of that visit.
Furthermore, at a traditional (insurance-based) physical therapy practice, in order to be in-network with insurance companies, clinicians agree to accept the insurance company’s rates, which are often low. As a result, providers will offset the reduced rates by increasing volume of patients they see. What this means is that patients might be booked alongside several others simultaneously, or, it will be recommended that you are seen 2-3x/week for 4-6 weeks.
In addition, most health insurance policies restrict the total number of visits you are allowed to seek physical therapy services. For those undergoing surgical intervention, this can be a major barrier to your full recovery.
Does this sound familiar?
At Uncommon Physical Therapy, we decided from the beginning to operate as a cash-based practice to eliminate these problems. Our emphasis is on quality over quantity to provide you with the most value.
Each visit with us is strictly 1:1, and can last anywhere from 30-60 minutes depending on your preference of services and specific needs. Our costs are publicly listed, as we believe in full transparency with our patients, clients and customers. And we will never limit your visits; if you need care, we are here for you. But remember, you still have options for seeking reimbursement for your physical therapy care. Speak with your health insurance company and see if your plan offers out-of-network benefits. If so, you may be able to submit the billing claim (what we call a superbill) to the insurance company for possible reimbursement.
As a final note, a recent study (see here)
comparing cash pay to insurance-based physical therapy found that cash-based services…
1. Decreased the total number of visits
2. Reduced the cost per visit
3. Decreased the overall cost for the entire treatment plan
As an example:
Traditional (Insurance-Based) Physical Therapy
- Cost Per Visit = $50 (co-pay)
- Total Visits = 12
- Total Cost = $600+ (does not include bills from services)
- Time Spent 1:1 with PT = 15 minutes/visit
- Total Time in Clinic = 180 minutes
- Cost Per Minute = $3.33
Cash-Based Physical Therapy
- Cost Per Visit = $125
- Total Visits = 5
- Total Cost = $625 (no additional bills)
- Time Spent 1:1 with PT = 60 minutes/visit
- Total Time in Clinic = 300 minutes
- Cost Per Minute = $2.08
I hope this information has been helpful. At Uncommon Physical Therapy, our goal has always been to empower our patients to make the best healthcare decisions. That is what the uncommon healthcare experience is all about.
For more information, visit uncommonpt.com
and schedule with us today!