Cost & coverage
Why we’re out-of-network
We made a deliberate choice: we don’t contract with commercial insurance companies. It isn’t about being exclusive. It’s about protecting the thing you’re actually coming for: your therapist’s full attention. Here’s how it works, what it costs, and why we think it’s worth it.
What it costs
You pay at each visit. We accept HSA and FSA cards. Please give us 24 hours’ notice to cancel; late cancellations are $75.
How your insurance fits in
Out-of-network
We are not in-network with any commercial plan. If your plan has out-of-network benefits, we provide a superbill (an itemized receipt with the codes your insurer needs), and you submit it for reimbursement.
Non-participating provider
We submit your claims directly to Medicare. You, or your secondary insurance, cover the 20% Medicare doesn’t pay, along with any deductible.
Why we do it this way
Your time is protected.
Every visit is one-on-one with the same physical therapist. No aides. No hand-offs. No juggling several patients at once. Insurance reimbursement is set per visit, and for many practices the math only works if a clinician treats several patients at the same time. We don’t. Whether your visit is 30 or 45 minutes, it’s yours alone.
Your care is built around you, not around a visit limit.
Insurers decide how many visits they will pay for, and often need to approve treatment in advance. Without that in the middle, your plan of care follows what your body needs and how you respond, not what has been authorized.
Less paperwork between you and your therapist.
Prior authorizations, claim disputes and coding fights all take clinical time. Ours goes to you.
Why the investment can be worth it.
Thorough, hands-on care costs more per visit. For many patients it can help avoid costly procedures and visits that don’t get them anywhere, and resolve problems that once seemed hopeless. That’s why we think it’s worth the added expense.
Using your out-of-network benefits
If you plan to submit bills to your insurance, ask your insurer at the start. Because we are not in any network, finding out what your plan requires is up to you. Before your first visit, please ask:
- Do I have out-of-network benefits for outpatient physical therapy?
- What is my out-of-network deductible, and how much have I met this year?
- What percentage do you reimburse for out-of-network physical therapy once it’s met?
- Does my plan require an authorization (advance approval), and what information does it require?
A short call or a look in your insurer’s app will tell you roughly what a course of care will cost you. If you’d like help making sense of it, ask us.
The best of both worlds
Already using your insurance benefits for physical therapy at an in-network clinic? You don’t have to choose. Many patients keep their covered visits and add time with us for the one-on-one, hands-on care those visits often can’t fit in.
Keep your benefits.
Your in-network visits continue as planned.
Add us where it counts.
Every visit with us is one-on-one with the same physical therapist, so you may not need to see us as often. Think of it as a complement to the care you already have.
One plan, not two.
With your permission, we communicate with your other practitioners so your care stays consistent. This often works very well.
Pay only for the extra care.
Our usual fees apply, with no commitment to a set number of visits.
Check your plan first.
We can’t know whether your insurer will reimburse our visits while you are also seeing an in-network provider. If you plan to submit a superbill, ask your insurer first.
Not sure it would fit your situation? Send us a message and we will talk it through.
Is this right for everyone?
Not necessarily, and we’d rather say so plainly. Paying at the visit and waiting on reimbursement isn’t easy for everyone, and we understand that cost matters. If you already use an in-network clinic, you may not need to choose (see above). If you’re weighing it up, send us a message and we’ll explain how it works for your situation before you decide.
Questions about cost?
Send us a message and we will contact you. You can also call (212) 366-4450 and leave a voicemail.