The following rates for a typical 1-hour session are effective 01/01/2022. Rates will be higher for longer sessions. We offer the following options for payment and / or reimbursement of services provided:
Medicare
We are currently a participating provider with Medicare, therefore we bill our usual rates and accept the Medicare fee schedule and terms. Medicare pays 80% of the allowed amount, and the Medicare beneficiary (patient) is responsible for the remaining 20%. If you have a secondary insurance policy, most if not all of the remaining 20% is usually covered by that policy depending on your specific plan.
Medicare Replacement Insurance
We are not a participating provider with any insurance company other than Medicare, however, most of the Medicare replacement insurance programs we have billed will reimburse nearly 100% of the Medicare allowed rates even for out-of-network providers like us. Since this is obviously dependent upon each specific policy and you will be responsible for whatever your insurance company does not pay, we strongly recommend that you contact your plan’s customer service representative to make certain of your out-of-network physical therapy benefits before using this payment / reimbursement option.
Self-pay
This is the simplest option. You pay for the session at the time of service and receive a significant discount.
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- Initial session: $140 (Billed amount $250 minus $110 self-pay discount)
- Follow up sessions: $120 (Billed amount $220 minus $100 self-pay discount)
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***MULTIPLE SESSION DISCOUNT*** We will discount every 6th session by an additional 50% ($60), thus you will only pay $60 for every 6th session! This additional discount lowers the average rate over 6 follow-up sessions to only $110.
Out-Of-Network Insurance
We are happy to bill your insurance company to take advantage of your out-of-network provider benefits. We will collect the maximum out-of-pocket amount from you at the time of service, submit the claim to your insurance company, and then refund you whatever amount your insurance company pays us for the claim. We strongly recommend that you contact your insurance company to make certain of your out-of-network physical therapy benefits before using this payment / reimbursement option.
Initial session:
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- Amount billed to insurance $250
- Maximum adjustment $50
- Maximum out-of-pocket $200
- Amount you pay is $200 minus whatever your insurance pays us
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This means that we will submit a claim of $250 for the session to your insurance company, adjust this amount up to $50, and collect the remaining balance of $200 from you at the time of service. We will then refund back to you whatever amount your insurance company pays us.
Follow up sessions:
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- Amount billed to insurance $220
- Maximum adjustment $80
- Maximum out-of-pocket $140
- Amount you pay is $140 minus whatever your insurance pays us
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This means that we will submit a claim of $220 for the session to your insurance company, adjust this amount up to $80, and collect the remaining balance of $140 from you at the time of service. We will then refund back to you whatever amount your insurance company pays us.