Barriers to receiving Physical Therapy care exist in all situations. For some, transportation and location can be deterrents to establishing care. Others may cite time away from work/family/sports, etc. One of the most common barriers I have experience with is the cost of Physical Therapy and the headache of dealing with insurance companies. Even working as a healthcare provider dealing with insurance companies is a nightmare for me. No wonder patients don’t want to deal with it either.
A lot of insurance company’s coverage of therapy services can come attached to cumbersome co-pays or co-insurances that are due at EACH visit. A plan of care (duration of the physical therapy sessions) at an outpatient facility commonly runs for a duration of 12 visits. Couple this with any deductible that hasn’t been met yet, or even running the risk or working with a provider that is out of network, the cost of therapy sessions can add up very quickly. Just to add insult to injury, once you get into physical therapy rarely do you spend an entire session with your Physical Therapist or Physical Therapist Assistant. I hear from so many patients that they are often seen with 2-3 other people at the same time and are often left alone to complete their exercises. Fellow physical therapists are just as frustrated with this model, they need to see this many patients at a time just to meet their minimum productivity standards.
There is a viable alternative to the status quo of obtaining physical therapy care. Cash based practices are popping up all over the place to counteract the negative aspects of traditional outpatient clinic setting. Therapists and patients alike are attracted to this model for a few reasons. As a Physical Therapist, I love the emphasis on 1:1 patient care. I get to hang out with my patient for 60 minutes that is uninterrupted by front office staff, insurance company inquires, patient rescheduling/questions, emails from managers, etc. It allows me to practice to my full potential and my patients achieve their goals in much fewer visits resulting in decreased cost for the patient and increased flexibility in scheduling because they come less frequently. Also, by providing the patient with the necessary documentation, they are able to submit a claim to their insurance companies and often be reimbursed for services that are covered by their plan or direct the money spent on physical therapy to their out of pocket deductible for the year. Often time this can actually contribute to a decrease in out of pocket costs over the course of the plan of care.
|MBT (Cash PT)||Clinic PT|
|Cost/visit||135/90||80 (co-pay or co-insurance)|
|Number of visits||4||12|
|Total Cost||$405 (1 Eval $135, 3 Returns $90)||$960|
|Time with Physical Therapist||90 min Evaluation
60 min return
270 total minutes
|45 min Evaluation
15 min return
210 Total minutes
The above table offers a very basic break down of what the savings can be with a cash based physical therapy plan. If this is something that interests you, I would be happy to discuss further benefits of cash based care! Shoot an email to firstname.lastname@example.org to find out more about how cash based physical therapy can help you live life with less pain.