Why Cash-based Physical Therapy?

Cash-based physical therapy, also known as a private pay or self-pay physical therapy, is an alternative to traditional insurance-based physical therapy. Instead of billing an insurance company, cash-based physical therapy practices charge patients directly for their services. While the upfront cost of paying cash for physical therapy may seem intimidating, this approach has several potential benefits. In this blog, we will explore the advantages of cash-based physical therapy, including the ability to choose a specialist, customized treatment plans that are more effective, and upfront pricing. We will also discuss the potential cost savings of paying cash for physical therapy and the convenience of avoiding insurance paperwork. If you are considering cash-based physical therapy for your health needs, this blog will provide valuable information to help you make an informed decision.

Here are ten reasons why cash-based physical therapy may be a better option.

1)More personalized care: 

One of the main benefits of cash-based physical therapy is the ability to provide more personalized care to patients. Because cash-based physical therapists do not have to deal with insurance reimbursements, they may have more time to spend with each patient. This can allow for longer one-on-one sessions with the therapist, allowing patients to receive more personalized care and attention.

In a traditional physical therapy setting, therapists may be under pressure to see a high volume of patients to make up for insurance reimbursement rates. This can lead to shorter visits and less one-on-one time with the therapist. In contrast, cash-based physical therapists can focus on providing high-quality, personalized care to each patient without the need to see a large volume of patients.

By providing more personalized care, cash-based physical therapists can take the time to assess each patient’s condition and needs fully and develop a customized treatment plan that is tailored to their specific goals. This can lead to better outcomes and more effective treatment, as the therapist can address each patient’s unique issues and needs.

2)Customized treatment plans: 

Another advantage of cash-based physical therapy is the ability to offer customized treatment plans that are tailored to each patient’s specific needs and goals under a single therapist.

In a traditional physical therapy setting, insurance coverage may limit treatment plans. Insurance companies may only cover specific treatments or therapies or may have limits on the number of visits that are covered. As a result, physical therapists may be restricted in their patient’s treatment options.

In contrast, cash-based physical therapists are not constrained by insurance coverage and can offer a broader range of treatment options without any restrictions. This can allow them to develop customized treatment plans that are specifically designed to meet each patient’s needs and goals.

Customized treatment plans can be more effective because they have tailored to the individual patient rather than a one-size-fits-all approach. Cash-based physical therapists can develop a treatment plan that is more likely to achieve the desired results by focusing on the patient’s specific issues and needs. This can lead to better outcomes, more effective treatment, and a more positive experience for the patient.

3)Upfront pricing: 

With Cash-based Physical Therapy, patients know exactly what they will pay for services upfront, rather than dealing with copays, deductibles, and other out-of-pocket expenses.

In a traditional physical therapy setting, patients may have to pay copays or deductibles for each visit, which can add up over time. They may also have to pay for services that are not covered by their insurance plan. This can frustrate patients and make budgeting for physical therapy treatment difficult.

In contrast, cash-based physical therapists typically provide upfront pricing for their services. This means that patients know precisely what they will be paying before they begin treatment, allowing them to budget and plan accordingly.

Upfront pricing can benefit patients who do not have insurance, patients with high deductible plans, or those without insurance that does not cover physical therapy. By providing transparent pricing, cash-based physical therapists make it easier for these patients to access the care they need without worrying about coverage issues or unexpected costs.

4)Potential cost savings: 

Cash-based physical therapy may lead to savings in the long run for patients. In a traditional physical therapy setting, patients may be required to pay copays or deductibles for each visit, which can add up over time. They may also need to visit the therapist multiple times weekly for several weeks or months to achieve the desired results. This can lead to high patient costs, especially if they have high copays or deductibles or their insurance does not cover all their treatment costs.

In contrast, cash-based physical therapy may require fewer visits and may be more effective in achieving the desired results. This can lead to savings for patients in the long run, as they may need fewer visits and may achieve their goals more quickly.

For example, the patient has insurance with a deductible of $5000 and a $25 copay for each visit to the physical therapy clinic. While receiving treatment, the patient will need to pay the $25 copay per visit and the cost of treatment, typically ranging from $100 to $150 per visit, until the deductible is met. After meeting the deductible, the patient will be responsible for paying a percentage of the cost until the out-of-pocket maximum is reached. It’s worth considering that insurance-based physical therapy clinics typically offer 30 minutes or more of one-on-one care per visit, which different therapists or assistants may provide. This type of treatment is typically recommended 2-3 times per week for 6-12 weeks, depending on the patient’s condition. This can result in total costs ranging from $1500 to $4200 for a two times per week, a 6weeks treatment plan. On the other hand, cash-based physical therapy practices often offer more extended sessions, up to 60 minutes, one-on-one sessions with a single therapist, utilizing more effective treatment techniques. As a result, patients may achieve the same results with fewer visits, typically 1-2 times per week for 4-6 weeks. Each visit to a cash-based physical therapy practice typically costs $150 – $175, resulting in a total cost of $1800 – $2100 for two times per week, a 6-week treatment plan.

In addition to the potential cost savings, cash-based physical therapy may offer added convenience, such as fewer visits and the ability to see the same therapist at each visit. It’s also worth considering that the number of visits to the clinic, travel time, and productivity savings from reduced discomfort and fewer visits to the physical therapy clinic may also be valuable to the patient. Ultimately, the potential for cost savings will depend on various factors, including the severity of the patient’s condition, the effectiveness of the treatment, and the length of the treatment plan.

Cash-based physical therapy is an HSA/FSA-eligible medical expense like any other physical therapy service. This means that patients can use their HSA or FSA funds to pay for cash-based physical therapy and may be able to save money on their taxes as a result.

5)No insurance coverage issues: 

Another advantage of cash-based physical therapy is that patients do not have to worry about insurance coverage issues.

In a traditional physical therapy setting, patients may have to deal with various insurance coverage issues, such as copays, deductibles, and exclusions. They may also have to navigate preauthorization requirements or deal with denied claims. These issues can be frustrating and time-consuming for patients and may lead to delays in getting the care they need.

In contrast, cash-based physical therapy eliminates the need for insurance coverage. Patients pay for the services they receive upfront without dealing with insurance bureaucracy or coverage issues. This can make it easier for patients to access the care they need without worrying about coverage or payment issues.

It’s worth noting that cash-based physical therapy may only be an option for some patients, depending on their financial situation and the availability of other resources. Cash-based physical therapy will provide you with a precise cost estimate through a good faith estimate, where you will know the cost of treatment even before you start the treatment.  Patients who are considering cash-based physical therapy should carefully consider their financial situation and determine whether this option is feasible for them. Before beginning treatment, they should also discuss the costs and payment options with their provider before starting a treatment.

6)Higher quality of care: 

One of the benefits of cash-based physical therapy is that it may offer a higher quality of care compared to traditional physical therapy.

In a traditional physical therapy setting, therapists may be under pressure to see a high volume of patients to maximize their reimbursement from insurance companies. Most of the visits are completed by a different therapist, and the patient may receive care from a physical therapy assistant. This can lead to less personalized care and may need to be more effective in achieving the desired results.

In contrast, cash-based physical therapy allows therapists to focus on providing patients with personalized care. This may include more one-on-one time with the same physical therapist, not an assistant, customized treatment plans, and the ability to address multiple issues simultaneously.

By removing the third-party insurance company from the equation, cash-based physical therapy gives patients more control over their care and the ability to choose the best fit to help with their specific needs and goals. This may lead to a higher quality of care and improved patient outcomes.

It’s worth noting that not all cash-based Physical therapy practices are the same; it’s better to choose a cash-based clinic with a good rating that offers unique treatments that the traditional physical therapy practice does not offer. For example, does Cash-based Physical therapy have any additional certification and special training, etc.?

The potential for a higher quality of care will depend on various factors, including the therapist’s skills and expertise, the treatment’s effectiveness, and the treatment plan’s length.

7)Freedom to address multiple issues at the same time: 

The other benefit of cash-based physical therapy is that it may allow patients to address multiple issues simultaneously.

In a traditional physical therapy setting, therapists may need more than one treatment and technique to resolve the issue they can’t use due to insurance restrictions. This may prevent the therapist from addressing multiple issues or conditions, as each condition must be treated separately.

In contrast, cash-based physical therapy allows therapists to develop customized treatment plans that address a patient’s specific needs and goals. This may include simultaneously addressing multiple issues or conditions, as insurance restrictions do not limit the therapist.

For example, a patient with chronic back pain and a history of headaches may be able to address both issues simultaneously in a cash-based physical therapy setting. The therapist can develop a treatment plan that addresses the patient’s specific needs and goals, such as improving flexibility and strengthening the back muscles to reduce pain, as well as addressing any issues related to the patient’s headache.

It’s worth noting that the potential to address multiple issues at the same time will depend on the specific needs and goals of the patient and the effectiveness of the treatment. Patients who choose cash-based physical therapy should discuss the possibility of addressing multiple issues at the same time with therapist before beginning treatment.

8)No need to worry about network restrictions: 

One of the benefits of cash-based physical therapy is that it offers patients the freedom to choose a therapist without the constraints of network restrictions.

In a traditional physical therapy setting, patients may be limited to seeing therapists who are in-network with their insurance company. This means that the therapist has agreed to accept the insurance company’s rates and may be bound by certain rules and regulations. Network restrictions can be a barrier to care for some patients, as they may need access to the therapist or treatment that they feel best suits their needs. Patients may also have to wait longer to see an in-network therapist or may have to travel farther to access care. Cash-based physical therapy allows patients to choose a therapist based on their own preferences and needs rather than being limited by network restrictions. Patients can seek out a specialist who has the skills and expertise to address their specific needs and goals, without the constraints of network restrictions.

9)Many insurance companies reimburse for out-of-network PT: 

While it is true that many insurance companies will reimburse patients for out-of-network physical therapy services, it’s essential to understand that this reimbursement may not cover the total cost of the services and can vary widely from one insurance company to another.

When a patient seeks physical therapy from an out-of-network provider, their insurance company may cover a portion of the cost. Still, the patient is typically responsible for paying for the treatment upfront, and the insurance company will reimburse the patient later after submitting the claim. This balance, known as the “out-of-pocket” cost, may be higher than what the patient would pay if they received treatment from an in-network provider. Insurance reimbursement for out-of-network physical therapy services can also vary depending on the specific insurance plan and the type of treatment being provided. Some insurance plans may have limits on the amount they will reimburse for out-of-network physical therapy, while others may not cover certain types of treatment at all.

It’s essential for patients to understand their insurance coverage and the potential out-of-pocket costs before seeking out-of-network physical therapy services. Patients should also be aware that they may need to pay for their treatment upfront and seek reimbursement from their insurance company later.

10)Freedom to choose treatment options:

One of the benefits of cash-based physical therapy is that it offers patients the freedom to choose treatment options that their insurance may not cover.

In a traditional physical therapy setting, patients may be limited to treatment options that are covered by their insurance. This means that the therapist must adhere to certain guidelines and protocols to be reimbursed for their services. While insurance coverage can be a valuable resource for patients, it can also be a barrier to care for some patients, particularly if they are interested in treatment options that are not covered by their insurance. For example, a patient may want to try a new therapy like Class IV Laser, INDIBA, Electro-Dry needling, Cupping, Shockwave Therapy, or treatment that still needs to be covered by insurance or may not be covered at all.

Cash-based physical therapy allows patients to choose treatment options that may not be covered by insurance without the constraints of insurance coverage. This allows patients to explore treatment options that may be best suited to their needs and goals without the limitations of insurance coverage. Your health is worth any amount and is the BEST investment you could ever make. One of the key arguments in favor of cash-based physical therapy is that it allows patients to prioritize their health and invest in their well-being.

While the cost of healthcare can be a significant concern for many patients, it’s important to remember that your health is an asset that is worth investing in. By prioritizing your health and seeking out high-quality care, you can improve your quality of life and reduce the likelihood of future health problems. Cash-based physical therapy can be a good option for patients who want to invest in their health and seek the best care. Because the constraints of insurance coverage do not bind cash-based physical therapists, they may have more flexibility to provide personalized, high-quality care that is tailored to each patient’s needs and goals.

By choosing cash-based physical therapy, patients can invest in their health and well-being, knowing that they are receiving the best possible care if care is taken from a well-experienced cash-based provider. While the upfront cost may seem daunting, the long-term benefits of good health and well-being can be priceless.

References

1. 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/
2. 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/
3. Janet Dolot, Deborah Viola, Qiuhu Shi, Matthew Hyland, Impact of Out-of-Pocket Expenditure on Physical Therapy Utilization for Nonspecific Low Back Pain: Secondary Analysis of the Medical Expenditure Panel Survey Data, Physical Therapy, Volume 96, Issue 2, 1 February 2016, Pages 212–221, https://doi.org/10.2522/ptj.20150028

Written By:

Dr.Siva Parnam, DPT

Physical Therapist / Osteopractor