Even with insurance, the cost of physical therapy can be steep. What’s the cost of physical therapy without insurance, and can you make it more affordable?
With insurance, the out-of-pocket cost of physical therapy or physical rehab depends on the services you receive, the type of therapy required, and what treatments are permitted under your insurance plan. Without insurance, the cost will depend both on the services you require and how willing your physical therapist is to work with you on payment and therapy structure. According to national benchmarks, physical therapists deliver an average of 3.4 weighted procedures during a physical therapy visit. The average Medicare allowable for services is between $26 and $30 per weighted procedure, bringing a single PT session to a cost of around $100. Clinics usually charge more than the amount allowed by the insurance and write off the difference. A cash patient may not benefit from the insurance adjustment, resulting in a higher cost.
Physical Therapy Costs By Procedure
Not every session will equate to $100. Some sessions may be less, some much more. Before you begin a physical therapy regime, the therapist must perform an evaluation. The evaluation is to assess your injury or condition and let the physical or occupational therapist design a treatment plan for the best results. The charge for an assessment could be $150 or more. After the assessment, the physical therapist may perform varied sets of procedures for each session. Some procedures are billable by the minute; the charge for gait training could be as high as $115 for each quarter hour, for example. Other common PT charges that are billed every 15 minutes include electronic stimulation, functional training, manual therapy, and therapeutic exercise. These can all cost between $75 and $135 per 15 minutes. Procedures that are usually billed at a flat rate include cervical traction, instructions for using PT devices at home, and supervised exercise. These services usually cost between $50 and $150 per procedure.
Negotiating on a Cash Basis
What’s the cost of physical therapy without insurance? If you can find a great physical therapist or clinic willing to work with you on charges, then it doesn’t have to be as high as the above section might indicate. The example charges provided are what clinics might charge for services. Insurance companies, such as Medicare, rarely allow the total amount. For an assessment, the PT may charge $150, but the insurance company might allow between $75 and $100, causing the clinic to write off the remaining $50. As a cash patient, you can negotiate rates with the therapist. Ask for a discount equal to average insurance write offs, and let the company know that you’ll pay cash up front so they can save money in the billing process. A service that is charged at $100 may only cost you $50 when you pay in cash.
Reducing Costs by Being a Good Patient
You can reduce the total cost of physical rehabilitation by being a good, attentive patient. Physical therapy is definitely an uncomfortable exercise for many, and you could be tempted to skimp on the effort you put in. When you’re footing the bill for the session, however, you want to push yourself so that you’re getting everything out of the therapy. In some cases, the harder you work, the faster your therapy will be completed, saving you the cost of future sessions. Many therapists will teach patients at-home exercises, which can reduce the number of sessions required each week. Talk to your therapist about your financial situation and lack of insurance and state that you’re willing to take responsibility for some of your therapy at home. Ask a trusted friend or family member to help you with home exercise. Instead of paying for four sessions each week, you might only need to pay a professional for one or two sessions. You could drop costs from $400 or $500 per week to $200 or less using these tips.
Reduce Physical Therapy Costs through Provider Selection
In some areas, community clinics or healthcare learning facilities offer an opportunity for patients with little or no insurance coverage to receive low- or no-cost physical therapy. When a physician orders physical therapy, speak with your hospital caseworker or physician office staff about available services in your area. Colleges may offer supervised training programs where you can receive free PT services. Community clinics often offer fee schedules on a sliding scale, setting rates according to your income or ability to make payment. Hospitals often have caseworkers who can guide you through the process of finding the most affordable physical therapy in your area. By understanding that insurance companies rarely pay the amount charged and working with therapists in your community on a physical therapy regime that works for you, you can reduce the cost of physical therapy to an affordable level, even without insurance.