Consider this scenario: You've had knee pain for weeks. It started as a sharp pain while running and now red-hot pain is the unwelcome companion for every aspect of your life. You can't sleep or stand up from a chair. You love to run, but that's out of the question. You're desperate for relief. Then a friend suggests a popular cash-based physical therapy practice that specializes in running injuries. 'Cash-based physical therapy' is also known as 'private pay' and 'self pay physical therapy'. It just means that your clinic won't bill an insurance company.
You're eager to get your regular life back again but you stop in your tracks when you're reminded—they don't take your insurance! So now your inner debate begins. You're tempted to find another provider because it seems so much easier to just use your health insurance.
So, should you ever choose to a cash practice instead of a traditional one? The answer is yes, there are 4 surprising reasons why paying cash for physical therapy yields better and faster results. Keep reading to find out what they are.
- Paying Cash for Physical Therapy is a Better Value
- You Will Have the Freedom to Choose a Specialist
- Customized Treatment Plans Are More Effective
- Paying Cash Comes With Upfront Pricing
Most health insurance policies don't cover the entire cost of a physical therapy visit. If cash-based physical therapy rates seem high to you, realize that even with health insurance, many patients are still responsible for copays and deductibles of $50 or more per physical therapy visit. So, you will usually pay out of pocket for physical therapy whether you use your insurance benefits or not. What is different is the overall quality of the services and the value you experience at each visit.
For a physical therapy clinic to be in-network with insurance companies, they agree to accept an insurance company's rates, which are sometimes low. As a result, the clinic will try to make up for the reduced insurance rates by increasing the volume of patients they see. This means that patients might be double or triple booked on one therapist's schedule.
The result is an impersonal physical therapy experience and poor continuity of care with the following possible consequences:
- Minimal face time with the licensed physical therapist, the expert you came to see
- Different physical therapists for each visit leading to scattered, inconsistent care
- Portions of your session supervised by a physical therapy technician or athletic trainer
Ultimately, the volume game traditional clinics must play significantly reduces the chances of you receiving quality care and will likely increase the number of visits you will require.
Cash-based physical therapists are out-of-network with insurance companies, meaning they refuse to compromise your quality of care. Removing the third-party insurance company from the relationship gives the purchasing power back to you as the patient looking for the best fit to help with your problem.
In a cash pay transaction, you are now the willing buyer with the ability to choose the right services. At the beginning of the relationship, you should agree upon the following terms with your therapist:
- The length of the treatment visit
- The amount of one-on-one time with your physical therapist
- Whether you will be treated by one therapist throughout the course of your care or if you will be helped by assistants or other staff
- The cost of each visit
- Options for communicating with your therapist outside of your session time
In fact, research indicates early treatment and paying cash for physical therapy reduces healthcare costs. When comparing cash pay to insurance-based physical therapy, a study examining patient records1 found that paying cash:
- Decreased the total number of visits
- Required less true cost per visit
- Decreased the overall cost for the entire treatment plan
In the end, when you are an integral part of developing the goals and setting the plan of care, you help ensure your own improved outcomes. Paying cash for the services puts you in the right position to make the right decisions about your care.
If you were shopping for a house or a car, you would probably research the best options before making such a large investment. Why wouldn't you apply that same mentality to your healthcare?
When an injury affects your ability to earn a living or your quality of life, you should find a physical therapist who specializes in your injury. However, not all physical therapists are the same.
Some physical therapists are highly focused on niche areas of practice. Getting this level of expertise requires time developing skills, obtaining certifications, and learning from treating a higher number of patients with that specific injury or problem. When you see a physical therapy specialist, you benefit from the cumulative effect of all that learning and practice.
Cash pay physical therapy specialists have the time and expertise to really dive into understanding your problem in a comprehensive way. They will develop a highly customized game plan for getting you better as quickly as possible.
Plus, you'll get the education you need to prevent future injuries or problems. Paying cash for such a specialist will increase the value of the services and improve your results.
First, you'll probably need to find the right therapist for your specific injury or concern. Finding the right physical therapist requires research about your injury and the specialized services required for recovery. You should take the time to learn about your injury, through conversations with your doctor and internet research so you can identify the right specialist.
Because cash pay physical therapists are out-of-network with your insurance company, they have the freedom to create a customized plan to address your injury, discuss your goals, and collaborate with you on a plan of care.
Furthermore, cash pay physical therapists are not playing the volume game by relying on large amounts of referrals to generate revenue. Rather, they are marketing their specialized skills and concierge services based on their ability to get results and provide exceptional patient care.
Remember, if you did your homework and identified the right physical therapist for your injury, you have found a provider who has invested in developing niche skills for helping you. They are dedicated to providing value and delivering results in as few visits as possible.
Your physical therapist can take the time to implement the techniques that will help you, answer your questions, adapt your treatment plan to your progress, and suggest improvements in your home exercise program.
By removing the headaches and demands of insurance companies, cash pay therapists are able to focus on what matters most: creating a personalized physical therapy experience where patients receive early access, attention, continuity of care, and immediate results.
Paying cash for physical therapy eliminates the mystery and math you would ordinarily experience when visiting an in-network therapist. In-network PT clinics charge an average of $250 per session to insurance companies. If you haven't met your deductible yet, you would be responsible for the full cost of the visit.
In contrast, CityPT follow-up treatments start at $99—less than half the cost of a traditional PT clinic. By eliminating the administrative overhead of billing insurance companies, cash pay physical therapists are able reduce their overall fees.
Since cash pay physical therapy practices are out-of-network with insurance companies, they are not constrained by contracted rates and other insurance contract restrictions. However, you still have options for getting reimbursement for your physical therapy care.
Talk with your health insurance company. If your health insurance offers out-of-network benefits, you can also submit the billing claim to the insurance company for possible reimbursement. In the context of rising healthcare costs and high-deductible insurance plans, it's actually a growing trend for people to take back control of their healthcare decisions with strategic ways of covering healthcare costs.2
CityPT therapists and nutritionists focus on personalized care for faster recovery. Early access, more time with your therapist, focused attention, and specialized training makes us highly effective in helping you return to your life and optimize your body.
If you want to know more about our services, please contact us. We provide our rates in advance and you can book an appointment directly with one of our therapists to have all your questions answered. We're committed to getting you the fastest care possible.
Before you go, please read our disclaimer. This blog is intended for informational purposes only. We are not providing legal or medical advice and this blog does not create a provider-patient relationship. Do not rely on our blog (or any blog) for medical information. Always seek the help of a qualified medical professional who has assessed you and understands your condition.
Pulford K, Kilduff B, Hanney WJ, Kolber M, Liu X, Miller R. Service utilization and costs of patients at a cash-based physical therapy clinic. Health Care Manag (Frederick). 2019;38(1):37-43.https://pubmed.ncbi.nlm.nih.gov/30640238/ ↩
Rosato D. How paying your doctor in cash could save you money. Consumer Reports. Published May 4, 2018. Accessed February 26, 2021. https://www.consumerreports.org/healthcare-costs/how-paying-your-doctor-in-cash-could-save-you-money/ ↩