Benefits of the Cash Pay Physical Therapy Model

Have you ever heard of cash pay physical therapy (PT)?! The cash pay PT model is a relatively new practice model in which PT businesses are not in contract with insurance companies. This means they set their own rates for reimbursement. The patient will typically pay on a per-session basis, or purchase a package of treatment sessions based on their own unique treatment needs!

Some clinics may identify as “out of network” which means they will provide a superbill, or detailed receipt, that patients can submit to their insurance companies on their own with the possibility of reimbursement. Providers cannot guarantee that services will be covered, so if you have out of network coverage it is best to call and ask what you can expect to get reimbursed for.

So what is the advantage of this business model for the PT?? It allows the PT to be paid what they deserve and eliminates the regulation from insurance companies on how we can treat our patients. Insurance companies dictate many aspects of care, including how many visits a patient can have, what type of treatment they are allowed to receive, and if they need a referral from a physician. Without the insurance company regulating these details, the patient and PT experience is much more desirable and effective.  

It may seem daunting to have to pay up front for PT, but it often ends up being even cheaper than insurance based PT. With increasingly high co-pays and deductibles, a PT session ran through insurance may cost as much as 500 dollars per session, whereas the national average for cash pay PT is 150 dollars per hour. 

If consumers have incredibly high deductibles, cash pay PT often ends up being the more economical option. In addition to lower hourly rates, patients can use both HSA (health savings account) and FSA (flexible spending account) options for payment for PT. Some employers even match or contribute to these plans which basically = FREE money for healthcare. For many FSA accounts, there is a “use it or lose it” policy for each year, so what better way to invest in yourself than purchase PT packages or digital fitness products?! 

So what does the cash-pay model look like from the patient experience perspective?? The cash pay model often translates to very high quality 1:1 patient care with the same PT each session. Cash pay physical therapy feels like a totally different experience, with regular client check-ins, personalized home programs, unique interventions and treatment approaches as well as the opportunity to talk about holistic topics such as nutrition and mental health. 

I recall a time while treating in a corporate, insurance driven PT practice that I would see upwards of 18 patients PER DAY. Each patient would get about 10-15 minutes of my split-attention before I would be forced to hand them off to an assistant or aide for the remainder of their session. Unfortunately, this type of care leads to poor patient outcomes and high rate of burnout among PTs. 

By switching to cash based PT, I now have the freedom to treat patients the way they deserve, exclusively with me (no use of aides or assistants) and I can also perform useful treatment methods such as dry needling, that is typically not covered by insurance companies!

I have an open line of communication with patients in regard to how many visits they would like, and we can even continue maintenance care well beyond the end of formal PT treatment. This means once you have met all “PT goals”, I can progress you even further with strength training and maintenance care while you become the most resilient form of yourself, a concept that is completely foreign and unrecognized by most insurance companies. 

The truth of rehab and recovery is that it can often be a long road. The traditional “fix it” model of care is simply outdated. Find yourself a PT who will be there for the long haul, and never stop working on helping you navigate the roadblocks in your ever-changing journey with health and wellness. 

If you haven’t tried cash-based PT yet, this is your sign to give it a try!!!