What is Direct-pay Physical Therapy?
Direct-pay Physical Therapy is the practice of Physical Therapy medicine where the clinician has an agreement with the patient to provide services to achieve the patient’s goals. The patient pays at the time of service or in advance if a “package of visits” has been purchased. This allows the Physical Therapist to fully provide his attention to the patient to provide the best high quality service while keeping administrative costs low. You may pay for services using actual cash, a check, or a credit or debit card.
Typically, Physical Therapy is covered by your medical insurance with your “In-Network” providers, where the providers bill your insurance with codes for physical therapy services provided (CPT codes). This can get very confusing, as the amount billed to insurance will vary visit to visit based on the exact services provided that day by the therapist. Direct-pay Physical Therapy, also called “Out of network”, eliminates this confusion and allows for clarity, as you pay the same amount per visit. So, in theory, you are paying for the Physical Therapist time. Documentation for evaluations, treatment visits, and progress notes are performed just like any “In-network” physical therapy practice and comply with all legal requirements.
Still Have Questions?
If you want to discuss our pricing, or any other concerns you may be having please get in touch.
Our goal is to provide the best affordable Physical Therapy care to you
What are the benefits of Direct-Pay?
There are many benefits of Direct pay Physical Therapy. First, the patient gets one on one attention each visit, as you are paying for the Physical Therapist time to devote his whole attention to you. Also, insurance companies limit what the Plan of Care or treatment plan should be for the patient, as the therapist will only treat what the insurance company will reimburse him for. In most cases this is not what is best for you. In Direct-pay physical therapy, the therapist will treat what his expertise and your needs dictate to reach your goals with a whole-body approach to therapy, increasing your chances of success. Lastly, most insurance companies assign you to a Therapist based on geographic location, and not expertise or quality. In Direct-pay Physical Therapy, you are paying for high quality and expert care to take care of your needs as we don’t have contracts with any insurance companies.
Can I get reimbursed through Insurance?
In most cases, Yes! Most insurance companies will provide payment for services received “out of network”. That depends on your insurance carrier and your payment plan, and it is the patient’s responsibility to check with their insurance carrier for coverage. Many patients choose to receive services out of network in order to see the physical therapist of their choice and the 1 on 1 attention they get. The end goal of documentation and billing is the same – to get paid – but in the case of Direct-pay services, it is the patient who is waiting for reimbursement rather than the provider.
Will I end up paying more for Direct-Pay?
In most cases, it is cheaper to do Direct-pay Physical Therapy than using your insurance carrier. Most patients have a $30-$50 co pay per in-network visit and you will be required to receive services 2-3 times per week, making it between $90-$150 per week just in co-pays. Also, like stated before, you will only be seeing for the condition your prescription is for and in a clinic where the therapist is seeing 2-3 patients at the same time as you to increase revenue. This is not the goal at Performance Sport Physio. At PSP, you will be seen once a week (most cases), with one on one attention, with the goal of developing a high quality whole body approach plan to meet your needs for in between $100-110 dollars per visit.
Florida also has a 30 day direct access law for Physical Therapy. This means that you can see a Physical Therapist for 30 days without a physician referral, which could potentially save you fees in diagnostic imaging (MRI/X ray), doctor visit co pays, and other fees that you may not need, as the Physical Therapist expert evaluation can determine the root of your problems in most conditions (see conditions we treat).
What steps are involved in submitting a claim?
The process is simple. Performance Sport Physio will provide you with an invoice, and you may submit that invoice and receipt to your insurance company for reimbursement. The invoice has all of the necessary information for your insurance company. This includes business name and address, tax ID, national provider identification and license numbers, as well as the patient’s ICD-10 (diagnosis) and CPT (billing) codes. You may choose to submit bills following each visit or one time after your Plan of Care is finished.
Here is what other people like you are saying about Performance Sport Physio
" I would highly recommend Performance Sport Physio for any and all of your PT needs!... "
" Within just two appointments with Mauricio and applying that work on a every other day basis outside of his appointments I have seen a major improvement inside the gym as well as my daily function. I am excited to continue working with him and get my body back to what it use to be, pain free. "
" Mo is great, I came in because I injured my ankle playing softball. He evaluated me and then worked with me to help me recover over the next month. I am back playing and I am better then ever thanks to Mo! "
" Mo, is great he explains everything very thoroughly, and is very knowledgeable!! He has helped me recover and become stronger then I was before! Highly recommend going to MO!! "
" This physical therapy establishment is highly recommended. A friend of mine referred me and I am very happy with my results so far. I see the therapist, Mauricio, and he is a very knowledgable,professional who is also very experienced. He spends the full hour with me explaining the techniques and exercises. "
" I have worked with Mauricio a few times to help treat my low back pain. He takes the time to understand my complaints and spends at least an hour personally with me to review exercises after he uses manual therapy including cupping and massage. I would highly recommend him and Performance Sport Physio to anyone who is trying to return to any level of activity or sport! "
3700 Ulmerton Rd
Licenced in Florida