05/01/2025
Did you know that our clinic offers self-pay options for patients whose insurance plans are out-of-network with us? Self-pay is also available to those without insurance!
Self-pay in physical therapy can offer several benefits to patients, especially when compared to relying solely on insurance-based care.
As a self-pay patient, you will have direct access to care, not having to worry about the hassle of first obtaining a referral. This means faster access to therapy by bypassing delays caused by the insurance approval processes.
Many insurance plans have high deductibles (often $1,500–$5,000 or more). Until that deductible is met, the patient pays 100% out-of-pocket anyway, often at the insurer’s higher contracted rate.
Many patients still owe a copay per visit ($30–$60) and possibly coinsurance after meeting the deductible.
With self-pay, patients can pay a lower flat rate upfront, avoiding inflated insurer-negotiated fees.
Non-specific Example:
Insurance rate for a PT visit: $300
Self-pay rate: $150
If your deductible isn’t met, you're paying $300 vs. $150 for self-pay.
Would you like to receive greater flexibility in your treatment? You and your therapist will have the ability to decide the frequency and duration of your treatments without being limited by insurance authorizations or visit caps. As a self-pay patient, therapists are not bound by insurance guidelines, allowing for more individualized and comprehensive care.
Self-pay patients have transparency of cost, knowing exactly what they are paying for with no surprise bills or hidden charges from insurance adjustments or denials.
Medical necessity is a common standard used by insurance companies to determine whether a treatment qualifies for coverage. Insurance may deny coverage after the visit (e.g., for not being medically necessary or needing pre-authorization), leaving patients with a large, unexpected balance. If a service is not deemed medically necessary, this causes financial and administrative strain on both the patient and the clinic.
Additionally, most insurance plans prioritize post-injury or illness care and typically do not cover services focused on prevention, wellness, or performance enhancement.
Wondering if self-pay might be a more cost-effective and health-conscious option for you?
If you are uninsured, we’re happy to work with you to create a plan of care that fits your needs.
If you do have insurance, please contact our office to confirm whether we are in-network with your insurance provider.
We look forward to continuing to care for our wonderful community!
