At Perform Strong PT, we make physical therapy insurance coverage simple by helping you understand your benefits and maximize your care.
In-Network Insurance Information
The fact that your insurance plan covers PT services—or any other services, for that matter—doesn’t necessarily mean you’re off the hook as far as payment goes. In many cases, you’ll still have to pay a deductible, a coinsurance, and/or a copayment. Perform Strong Physical Therapy wants to be as transparent as possible when it comes to insurance costs for therapy. Here are some common questions asked by patients:
What is a deductible?
This is the total amount you must pay out-of-pocket before your insurance starts to pay. For example, if your deductible is $1000, then your insurance won’t pay anything until you have paid $1,000 for services subject to the deductible (keep in mind that the deductible may not apply to every service you pay for). Furthermore, even after you’ve met your deductible, you may still owe a copay or coinsurance for each visit.
What is a copay?
This is a fixed amount that you must pay for a covered service, as defined by your health plan. Copays usually vary for different plans and types of services. Typically, you must pay this amount at the time of service. Again, copay amounts are fixed—which means you will always pay the same amount, regardless of visit length. In some cases, copayments count towards your deductible.
What is coinsurance?
This type of out-of-pocket payment is calculated as a percentage of the total allowed amount for a particular service. In other words, it’s your share of the total cost. For example, let’s say:
- The estimated allowable amount billed for your PT visit is $100-$120.
- You’ve already met your deductible.
- You’re responsible for a 20% coinsurance. In this situation, you’d pay an estimate of $20 to $24 at the date of service. The insurance company would then pay the rest of the allowed amount for that visit. Keep in mind that the coinsurance amount may vary from visit to visit depending on what services you receive.
Perform Strong Physical Therapy is in-network with:
*Highmark Blue Cross Blue Shield
*Humana – Certified Provider
Out-of-Network Insurance Information
Out-of-network coverage will vary per the insurance company and plan, and because this is a health-related service, patients can still use their HSA card for co-pays and/or co-insurance charges.
Perform Strong Physical Therapy serves as an out-of-network provider with:
Cash Option Physical Therapy Rates
$120 – Initial Examination and Evaluation
$100 – Follow-up Sessions
$50 cancellation fee within 24 hours of the scheduled session
*Introductory rates subject to change
