Most of us generally think of physical therapy as an insurance based service. However, many physical therapists (ourselves included) have cash pay rates or private pay rates. So, why exactly would someone choose private pay physical therapy?
Someone might choose cash pay physical therapy for direct access to personalized care without insurance restrictions, the ability to tailor treatment to their specific needs, and the convenience of avoiding paperwork and pre-authorization processes.
In this article, we’ll discuss the pros and cons of choosing cash pay as an option for physical therapy, typical physical therapy cash pay rates, and discuss its potential implications on your rehabilitation process.
Typical cash based physical therapy rates
Physical therapy private pay rates can vary widely depending on factors such as location, provider expertise, practice setting, and the specific services offered. Generally, cash pay rates for physical therapy sessions range from $75 to $125 per session.
However, some more specialized therapists may charge $250 or more per session. It’s typical for physical therapists who are known for their specific expertise on a particular intervention to charge more; these are likely the ones being sought out specifically.
Additionally, choosing cash pay can open up your options as there are PT clinics that have opted to be cash pay only.
As we mentioned in our article on how much physical therapy costs overall, most physical therapists aren’t billing by the hour, but rather for the individual services and modalities provided in the session. However, when private pay is involved, it may be more likely that you’ll run into physical therapists who bill for their time, rather than the individual services.
Regardless, billing for CPT codes is still the most common approach.
Factors that affect private pay physical therapy rates
These rates may also vary based on:
- The complexity of the treatment provided
- Additional services such as manual therapy or specialized modalities
- Any discounts or package deals offered by the physical therapy clinic
Some practices may offer discounted rates for multiple sessions purchased upfront or for certain populations, such as seniors, students, or veterans.
Since we’re not getting insurance involved, it’s common for physical therapy practices to be willing to budge a little more on their pricing when cash pay is involved, since they’re getting to avoid the process of dealing with insurance billing (and saving money on administrative costs).
Since choosing cash pay as an option is less common than billing insurance, many physical therapists don’t advertise their cash pay rate unless they’ve chosen to be a cash based physical therapy practice as their sole business model. If you’re wondering what a physical therapy practice near you charges its private pay patients, we recommend reaching out to them directly.
Additionally, insurance coverage, if available, may impact the out-of-pocket cost for cash pay services, as some individuals may choose to submit claims for reimbursement through their insurance plans.
Advantages and benefits of cash pay physical therapy
Private pay physical therapy offers several compelling reasons that may influence individuals to opt for this payment model over insurance-based therapy. Here are some key motivations behind choosing private pay:
Direct access to care
Though referrals for physical therapy aren’t strictly necessary, many patients still don’t come to us until a doctor has recommended that they give us a call. Additionally, processes such as verifying insurance, seeking authorization from the insurance company, and dealing with fee schedules can take a little bit of time.
With cash based physical therapy, all of these administrative tasks are eliminated, streamlining the process dramatically. With cash pay physical therapy, you can often see the therapist within 24 hours of your initial call, no problem.
Personalized care and attention
With private pay, therapists can dedicate more time and resources to each patient, fostering a closer therapist-patient relationship and enabling a higher level of individualized care.
Oftentimes, cash based physical therapy has more freedom in designing the treatment plan to fit the patient. Though the basics of the exercise program and home exercises may remain the same, the modalities may be different.
Especially among more specialized therapists with higher rates, longer treatment sessions and more one-on-one attention are hallmarks of private pay physical therapy, enhancing the overall quality of the patient experience.
Flexibility in treatment options
Private pay physical therapy affords therapists greater flexibility in choosing treatment modalities and techniques based on the patient’s unique needs, preferences, and goals.
Therapists can explore innovative approaches and alternative therapies that may not be covered by insurance but hold promise for optimizing outcomes and enhancing the patient’s overall well-being.
No visit limits, authorization hold-ups, or spending limits
While insurance is a godsend for unexpected medical expenses, it can also place restrictions on therapy, such as visit limits or spending caps. For this reason, seeking physical therapy without insurance can have its advantages. While most patients are able to recover within this window, there is a contingency of patients who won’t.
These cases are generally more complex or chronic, and sometimes a patient is engaging in physical therapy sessions for multiple months or years at a time. For these patients, limits to the number of visits or authorization from insurance can be very burdensome.
Speedier recovery in some cases
In some cases, we have to wait for authorization from insurance companies which can take days or even a full week. From a continuity of care standpoint, this is not ideal. So, in addition to cash pay options providing a faster initial experience on the front end, it can eliminate these gaps in the treatment process as well.
By bypassing insurance-related administrative processes and wait times, private pay physical therapy can expedite the rehabilitation process, enabling patients to achieve faster recovery times and return to their normal activities, work, or sports sooner.
Continuity of care
Private pay physical therapy fosters continuity of care by allowing patients to work with the same therapist throughout their rehabilitation journey. This consistency enables therapists to develop a deeper understanding of the patient’s condition, progress, and goals, leading to more effective treatment outcomes and long-term success.
Potential downsides – when not to choose private pay physical therapy
While cash pay physical therapy offers several advantages, such as direct access to care and personalized treatment, there are also some downsides to consider:
Private pay can be more expensive overall
One of the most obvious drawbacks of cash pay physical therapy is the out-of-pocket expense.
Though it isn’t true across the board (one notable exception would be high-deductible insurance plans), cash pay physical therapy rates are often more than copays negotiated by insurance companies. It can often be even more expensive than out-of-network physical therapy.
In essence, patients seeking private pay physical therapy services are trading convenience, choice, and continuity of care for a more expensive option overall.
If you’re at risk of financial strain from choosing private pay, we recommend you get in touch with the individual provider in question – they can provide you with their cash pay physical therapy rates directly, and perhaps even verify your insurance so you can weigh the options for yourself.
If you’re very set on a certain provider that can’t be covered by insurance, mention this to their administrative staff when you speak with them – it’s common for this to be the conversation where physical therapy practices are willing to negotiate in exchange for multiple visits paid up-front.
Potential limited coverage for additional services
Cash pay physical therapy may not cover certain additional services or modalities that are typically included in insurance-based therapy.
For example, individuals paying out-of-pocket may have limited access to specialized equipment, modalities such as ultrasound or electrical stimulation, or adjunctive services like dry needling or therapeutic taping.
This limitation could impact the comprehensiveness of their treatment and potentially affect outcomes.
Next steps
Overall, while cash pay physical therapy offers certain benefits such as direct access to care and personalized treatment, it also presents challenges related to cost, accessibility, reimbursement, financial strain, coverage limitations, and variability in quality.
Individuals considering cash pay physical therapy should weigh these factors and explore alternative payment options to ensure they receive the care they need.
