I am an Out-of-Network (OON) provider with all commercial insurance companies including Medicare Advantage plans (Part C Medicare Plans), and most Supplemental Medical Plans (Part F and G Medicare Plans). I am contracted with Original *Medicare (Part B Medicare plans) as a Non-Participating Medicare Provider. This means that patients who schedule with me, pay for their visit at the time of their appointment.

*If you have an a Part B Medicare plan please reference the Medicare Physical Therapy Patients Tab Below, for additional information about treatment rates.

Treatment Rates:

• Initial Evaluation (60 Minutes): $250

• Follow-up Visit (60 Minutes): $200

After over 5 years of practice in the insurance based medical system, I choose to become an Out-of-Network Provider with commercial insurance companies, to prioritize quality patient care. Being an Out-of-Network provider allows me to offer individualized treatment that is not dictated by your insurance company. It allows me to offer more holistic and trauma informed care, that isn’t rushed in a short appointment. Instead of the common Physical Therapy appointment model in which appointments are 30-40 minutes, or even double booked with another patient, appointments with me are actually 60 minutes. I work with one patient at a time for the entire appointment.

Many insurance plans have Out-of-Network benefits. Depending on your insurance plan, seeing me as an Out-of-Network Physical Therapist may actually save you money.

I can provide you a superbill upon request, to submit to your insurance company for reimbursement. Please note, reimbursement amount depends on your insurance plan and its OON benefits.

I understand that being an OON provider is a barrier to care for some patients. Pelvicrehab.com is a free online directory you can use to search for another pelvic floor therapist who may be in-network.

Unlike other health insurance companies, The Center for Medicare Services (CMS) does not allow Physical Therapists to be “In-Network” or “Out-of-Network” with Part B Medicare Plans. Instead, CMS gives Physical Therapists three options:

1. Apply to be a Participating Medicare Provider

2. Apply to be a Non-Participating Medicare Provider

3. Have no relationship with medicare. Physical Therapists who have no relationship with Medicare are legally restricted in treating Medicare patients for services that are normally covered by Medicare.

I have chosen to be a Non-Participating Medicare provider, because it is important to me to keep serving patients with Part B Medicare Plans.

If you have a Medicare Advantage Plan (Part C), or a supplemental Medicare Plan (Part F or Part G), insurance coverage works a little differently. If you have a Part C plan or a Supplemental Plan, I will likely be considered an “Out-of-Network” Provider instead of a “Non-Participating” Medicare Provider.

Regardless of what type of Medicare Plan you have (Part B with or without a supplemental plan, or a Medicare Advantage Part C plan) if you schedule with me you will pay for the visit at your time of service- but at a discounted rate.

Estimated Medicare Patient Treatment Rates (discounted based on the CMS Fee Schedule) are approximately:

• Initial Evaluation (60 Minutes): $200

• Follow-up Visits (60 Minutes) $150-180

Following your visit, I will submit your Physical Therapy claim to Medicare or your Medicare Advantage plan on your behalf, so that your insurance plan may reimburse you according to your specific benefits.

Please note, we cannot guarantee what Medicare or your Medicare Advantage plan will reimburse you. because reimbursement rates depend on your individual insurance plan benefits. If you would like an estimate on what your insurance plan will reimburse you, we recommend you contact your insurance company directly (start by calling the customer service number located on the back of your insurance card).

• Initial Treatment/Follow-up Visits (60 Minutes): $125

  Longer and shorter appointments may be available upon request. Email info@cedarphysicaltherapy.com to request a longer or shorter appointment.