Table of Content
- Organize Your Patient Forms
- by train, bus or car
- What companies run services between Frankfurt central train station, Germany and Strasbourg, France?
- Senior Director / Vice President - TCR Therapy Research
- Rules to follow in France
- Bus via Frankfurt Flughafen T1
- Three reasons that PT services are not covered by Medicare
- You can Provide the best possible care, free from insurance hassles and declining reimbursements.
You must submit the claims with a KX modifier (if it is between $1900 and $3700) and make sure your documentation supports the medical necessity. You can only begin taking self-payment if you get to a point at which you believe that the services are not medically necessary. Similar to above, if the service would normally be covered by Medicare, you cannot accept self-payment. You must bill Medicare directly for covered services provided to Medicare beneficiaries.
Thanks so much for your question, and I’m so sorry I’m not able to give you a clear answer at this time. I believe you can also change your status with Medicare during the open enrollment period… I.e. change from participating to non-participating, but this of course would NOT be a full deactivation/termination of the relationship. Thank you for pointing out Mary and Rick’s questions above… I didn’t see them come through so they were sitting there unanswered.
Organize Your Patient Forms
They cannot force any of us to create a relationship with Medicare. As I describe above, you can have no relationship or you can choose to be either “participating or non-participating” . I actually wouldn’t have known how to answer that one before she responded. As with anything related to Medicare, I would double and then triple check with CMS … you’ll often get different answers every time you call.

You would first need to find out if “massage therapy” is a “covered service” under Medicare. If it is not a covered service, then you should be able to offer it on a self-pay basis. The patient should also be informed of what the services will cost. On the ABN they sign, the estimate of the cost should be included on the form, and what they actually pay needs to be within $100 or 25% of the estimate.
by train, bus or car
Most health insurance policies don't cover the entire cost of a physical therapy visit. If cash-based physical therapy rates seem high to you, realize that even with health insurance, many patients are still responsible for copays and deductibles of $50 or more per physical therapy visit. So, you will usually pay out of pocket for physical therapy whether you use your insurance benefits or not.

As a PT, you are already a musculoskeletal expert, and there will be certain patient populations that you gravitate towards and enjoy treating. When you begin to speak to this, your niche may naturally reveal itself. It is important to have a niche population you want to serve. This prevents you from trying to be everything to everyone all the time. It also allows you to focus the message that you send to prospective clients. Your "perfect patient" should have characteristics that you enjoy working with.
What companies run services between Frankfurt central train station, Germany and Strasbourg, France?
We can still choose to have no relationship at all with Medicare. As for the rates you charge the self-pay patient, I DO believe that you are still limited by the MC fee schedule allowable amounts (for skilled PT ‘covered’ services). If you are providing non-covered services like fitness or wellness, you can price them at whatever the free market will support. I am a physical therapist 20+ years, and soon to be personal trainer.
If there was ever something PTs should learn more about, it’s marketing. You can get active on social media and start building up your email marketing campaign. You might think you have to take a bunch of courses in a certain field before you're considered an expert in a niche area, but that is not the case.
Failure to comply with Medicare rules in every case, even with best intent, could result in a federal investigation, fines, or other legal action. The Medicare Benefit Policy Manual is available in full as a series of downloads at CMS.gov; outpatient physical therapy benefits are discussed in Chapter 15, which is currently 289 pages. There are multiple routes that cash-based practices can take in terms of billing their patients, but they do not have to submit to insurance. Out of network physical therapy providers do not belong to the insurance company’s network, and no contract exists between provider and insurance company. Providers do not necessarily have to abide by and partake in the in-network guidelines for billing set by the insurance company for a patient that they treat when they are out of network.

I couldn’t have done it without Jarod and his content, and I know that otherwise I’d still be slaving away, burnt out, and significantly worried about my the future. Regardless of the relationship a physical therapist chooses to have with payers, it is essential to practice in compliance with all laws and regulations. Out-of-network, or cash-based, models can allow PTs to avoid restrictions placed on their services by third-party payers that interfere with their ability to help patients reach their goals. Unfortunately, that is not allowed; physical therapists may not opt out of Medicare. We are not providing legal or medical advice and this blog does not create a provider-patient relationship. Always seek the help of a qualified medical professional who has assessed you and understands your condition.
Mindful Matters Wellness can charge less because the simplified cash-based fee structure streamlines billing and does not require hiring billing personnel or paying fees to a third party billing service. This allows Mindful Matters Wellness staff to focus all energy on patient care, and allows patients to make informed decisions regarding the costs of their health care choices. In many cases, the out of pocket expenses for a course of physical therapy will actually be LESS for services provided at Restore Physical Therapy. In large part, this is due to the ability to charge less per visit, with these charges being well below the national average charge submitted to insurance in a typical fee for service outpatient practice.
Finding a customizable all-in-one system that will allow you to keep your patient files, documentation and payment methods in one place that is HIPAA compliant will decrease the stress of the business side of your practice. A key feature that has more recently come to light is the use of telehealth as a physical therapy service. More and more physical therapists have incorporated telehealth into their daily routines, and so integrating that into a telemanagement platform can ease the process of adding it to your everyday services. Healthie offers a cloud-based EHR and telehealth platform that is quick to implement while supporting compliance with HIPAA regulations — while being customizable to meet your business needs. Patients then pay on the date of their physical therapy services via cash or credit card.
What is different is the overall quality of the services and the value you experience at each visit. You are a non-participating provider, which means you can accept cash payment at the time of service, but you still must send the claim to Medicare. The patient will then receive reimbursement from Medicare. The quickest challenge you may look in transitioning into an all-cash practice might be discovering approaches to hold as many patients as possible and drawing in more new patients and growing referrals. For patients who stay and get reimbursement, it’s imperative that your team make the process as uncomplicated and straightforward as possible. With regards to attracting new patients, an all-cash policy may seem less service centered than competitors that bill insurance.
Including patient testimonials is a great source of added support for your practice. When looking for HIPAA-compliance in a telehealth tool, there is no need to search for an add-on to what you already use to run your business. Choosing an integrated EHR and telehealth platform that is fully HIPAA compliant ensures that your client’s private health information is protected every step of the way. Preparing a pediatric patient who will need ongoing physical therapy into adulthood may require years of planning. PTs are using a variety of cash-based practice models to meet their patients’ needs.