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Fee for Service 

Fee For Service Model: 

 

Your therapy sessions are catered to your individual needs and not dictated according to billing codes. Your PT sessions will be dedicated to personalized 1 on 1 manual care instead of redundant and time consuming paperwork. Each patient will be provided a “superbill” at their request to submit to their own insurance company for partial or full reimbursement. To assist in your decision making I have provided the codes that are typically billed for the first and follow up appointments below. If you call your insurance company they can tell you what dollar amount they reimburse for these codes in advance of your session. Please note: Medicare is separate due to unit per 60 minute session limit. Some insurance companies such as BCN reimburse at a flat rate regardless of the amount of time spent in the clinic or what is done. I will be out of network for all insurance companies that classify this way. 

 

Payment is expected in full at the time of service and then the superbill can be submitted by you for your reimbursement. Fee is 320 for the initial evaluation and 230 for follow up appointments. Payment can be made by card or HSA on the scheduling page when you click on Book Appointment button. 

 

A more detailed look.......

To assist in your decision making I have provided the codes that are typically billed for the first and follow up appointments below. If you call your insurance company they can tell you what dollar amount they reimburse for these codes in advance of your session. Please note: Medicare is separate due to unit per 60 minute session limit. Some insurance companies such as BCN reimburse at a flat rate regardless of the amount of time spent in the clinic or what is done. 

Typical first visit: Medicare

2 units Manual Therapy (97140)

1 unit Therapeutic Exercise (97110)(97140)

1 unit PT Evaluation: Low Complexity (97161)

Typical Follow up visit: Medicare

3 units Manual Therapy (97140)

1 unit Therapeutic Exercise (97110)

Typical first visit: All other insurance companies 

3 units Manual Therapy (97140)

1 unit Therapeutic Exercise (97110)(97140)

1 unit PT Evaluation: Low Complexity (97161)

Typical Follow up visit: All other insurance companies

4 units Manual Therapy (97140)

1 unit Therapeutic Exercise (97110)

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