CASH-BASED VS. INSURANCE

Cash-based physical therapy allows for personalized care; insurance-based care often requires physical therapists to work for the insurance company rather than the patient. 

Due to progressively worsening reimbursement rates and pressure from insurance companies, the therapist at in-network clinics must see at least 2 patients per hour (usually many more) and they often use technicians, assistants, and trainers to provide much of the actual patient care. The care often includes modalities like heat packs and ultrasound and, a significant part of the patient's time at the clinic is spent doing exercises they could do on their own time. Also, the clinics tend to require patients to attend 2-3 appointments per week and extend care to 6-8 weeks. 

Deductibles and PT copays have dramatically increased in recent years. Many patients who have not met their deductible pay less out of pocket for our treatments than they would if they went to a clinic that "takes their insurance."

Before deciding on where to get PT based solely on which clinics "take your insurance," make sure you know how much you'll be paying at your in-network options versus APEX, which is out-of-network or cash-based. 

Some insurance plans provide zero coverage for PT visits or require copays of over $50 per visit. And if you have a deductible to meet, you'll likely end up paying the full bill for you PT sessions until you meet the deductible (and these bills are often $200+ per session.) Sometimes patients will not start receiving the $200+ bills until after you've been getting care for 6-8 weeks and have racked up a significant total balance (again, often being asked to attend PT 2-3 times per week.) 

In addition, just because you're paying $200+ per session at a clinic that is in-network with your insurance does not mean that your insurance is applying that full amount towards your deductible! They often only apply the amount that they have agreed is reasonable for your PT sessions which is, of course, far less than the PT clinic actually charges.