Private Pay/ Cash-Based Physical Therapy

Please note, Within PT is out-of-network with insurance carriers.  We can provide an invoice with all required information to submit to insurance for possible reimbursement upon request.

We currently accept: Cash, Check and Venmo

General Coverage

1. Do I have out-of-network benefits for PT?

2. What is my deductible & how much of it have I met?

3. What percentage of out-of-network PT services will be reimbursed after I meet my deductible?

4. Is there a limit on the number of PT visits per year?

Reimbursement & Billing

5. Do I need a physician’s referral to qualify for reimbursement?

6. Do I need to get pre-authorization for PT?

7. What is the process for submitting a claim for reimbursement (forms, timelines, etc.)?

8. Are there specific billing codes (CPT codes) or diagnosis codes I need the provider to include?

9. Will I be reimbursed at the usual or a fixed amount per visit?

Terminology Clarification

10. What is considered a “covered service” vs. a “non-covered service” under my plan?

11. How is “medical necessity” defined for physical therapy services?

HSA/FSA Use

12. Can I use my HSA or FSA to pay for out-of-network physical therapy services?

13. What documentation is required to get reimbursed from my HSA/FSA account?

*** Within PT is here to help you... reach out with any questions

 Why Choose Private Pay PT? 

• Direct Access: Patients can seek treatment without a physician's referral in many cases. This can lead to faster access to care. 
•  Quality of Care: Cash-based practices often have more control over treatment plans and can allocate more time per patient, resulting in higher-quality care and individualized attention. 
•  Privacy: Patients may appreciate the added privacy, as their treatment details are not shared with insurance providers. 
•  Flexibility: Therapists have greater flexibility in treatment approaches and can focus on evidence-based practices rather than adhering to insurance protocols 
•  Extended Appointments: Longer appointment times allow therapists to thoroughly assess and treat patients, which can lead to quicker recovery. 
• Speedier Recovery (in some cases): By bypassing insurance-related administration processes and wait times, private pay physical therapy can expedite the rehab process, enabling patients to achieve faster recovery times and return to their normal activities, work, or sports sooner.