Original Medicare (Not Medicare Advantage Plans)

I expect to have credentialing by late November 2025, allowing me to bill medicare for you. Original Medicare allows me to bill a full hour of treatment for you. Choosing this as your medicare option does not require consistent re-authorizations the way advantage plans do, and we can fairly easily get you 30 visits without too much trouble, and up to 60 max per year for all therapies.

Priority Health Advantage Medicare Plans

Priority Health is closed to all new physical therapy businesses. I do not anticipate that they will open applications for businesses like mine for the foreseeable future. All advantage plans pay according to medicare rates and allow a full hour of treatment. If you have a priority health advantage plan and really want to use our services, consider changing your plan during Fall open-enrollment which ends Dec 7.

All Medicare Advantage Plans (BCBS, United, Aetna, Molina, and Others)

Unlike Original Medicare, advantage plans require considerable justifications to continue with skilled physical therapy care at the clinic. This creates a burden on the both the physical therapist and the patient. Keeping you authorized for therapy requires a higher level of documentation detail to try and meet the insurance standard to continue care. You need to be bad enough that you need therapy, but not good enough to simply continue exercises at home. It causes both the PT and patient a great deal of stress.

Blue Cross Blue Shield, Blue Care Network & Other Private Insurances

I do plan to be credentialed with BCBS. Their credentialing process is stringent and lengthy. I expect to finish this process by March 1, 2025. Depending on the particular plan, appointment times will be between 30min to 60min, and will have limits on number of visits.

Other insurances, like Aetna, Humana, and United should be on board by Feb 1, 2025. Nearly all of these plans will only allow for a 30 min visit based on payment rates. Expect the number of approved visits to be quite limited.

Priority Health Private Insurance Plans (HMO & PPO)

Priority Health is closed to all new PT businesses. I do not anticipate that they will open applications for businesses like mine for the foreseeable future. Priority Health typically has a $45 copay for PT visits and most approved facilities will only allow you 30 mins or less with a physical therapist. Therefore, you’re cost is $90 for a full hour with a PT. That cost is very similar to our discounted cash-pay plans. We keep our cash pay plans very reasonable and affordable for you, given the costs of insurance premiums, deductibles and co-pays. We keep it affordable.

Health Sharing Plans (Like CHM Christian Healthcare Ministries)

For those of you who are not familiar with Health Sharing Plans, I highly recommend them and I use CHM for myself. The best time to join these plans is prior to any formal diagnosis as they do have pre-existing conditions limitations. But even if you have diagnosis, check them out and see if you can live with the pre-existing wait times. I will work with anyone if you have CHM or a similar program until you receive the reimbursement check.

Cash Pay Options

    • 30 min wellness treatment $60

    • 45 min wellness treatment $90

    • 60 min wellness treatment $120

    • 90 min wellness evaluation $180

    • Standard Wellness Package $400 Includes eight half hour sessions

    • Premium Wellness Package $575 Includes 12 half hour sessions

    • Silver Holistic Package including one full 90 min evaluation followed by 8 one-hour treatments including all treatment methods $910

    • Gold Holistic Package including 1 full 90 minute evaluation followed by 12 one-hour treatments including all treatment methods $1225

    • Work-out Plan: Samantha will come to your home or gym of choice to setup a safe workout plan for you $150

    • Keep It Going Package: This package includes 12 monthly half-hour in-person followup appointments, and two workout plans that will help you to maintain your progress $900

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