Private Pay vs. In-Network : Breaking Free for Better Care

At Impact Performance Physical Therapy, We’re Different on Purpose.

We know the decision to go with a private pay practice can feel overwhelming, but we want to explain why it’s worth it—and how it can actually save you time, money, and frustration.

As a private pay practice, we are not in-network with insurance companies. Why? Because we believe in working for you, not for the insurance companies.

Navigating the world of health insurance is frustrating. Insurance companies are notorious for:

• Denials and Delays: Many plans require prior authorization for physical therapy, delaying your care for days—or even weeks.
• Low Reimbursements: These force clinics to double- or triple-book patients just to keep their doors open, sacrificing the one-on-one attention you deserve.
• Treatment Restrictions: Insurers dictate what can be treated and how many visits you get, regardless of your actual progress or goals.

This model is broken, and it’s not fair to you—or us. That’s why we’ve chosen to remain an out-of-network provider.

Here’s what that means for you:

• Transparent Pricing: Our flat rates are simple, straightforward, and all-inclusive.
• Quicker Progress: One-on-one, focused care means fewer sessions to achieve your goals.
• No Surprises: Say goodbye to unexpected bills or limitations dictated by insurance policies.
• More Comprehensive Care: We focus on what YOU need—preventative, wellness, and performance services that insurance often doesn’t cover.

We also understand that private pay may seem more expensive upfront, but in reality, it can often save you money. Many patients with high-deductible plans end up paying out of pocket for care anyway, while private pay offers better outcomes in fewer visits.

If you have insurance, we are happy to provide a superbill for potential reimbursement through your plan’s out-of-network benefits.

What You Should Know About Health Insurance

Understanding how your plan works is key to making informed decisions about your care. Here’s a quick guide:

• Deductible: The amount you must pay out of pocket before your insurance kicks in. High-deductible plans often range from $1,000 to $5,000 or more.
• Coinsurance: Once your deductible is met, you’ll pay a percentage of the costs—often 20-30%—until you reach your out-of-pocket maximum which can be up to $9,000 per individual. 
• Copays: A fixed amount you pay for each visit, which can range from $20 to $100 or more, depending on your plan.
• Prior Authorization: Some insurers require pre-approval before starting care, which can delay your treatment significantly.
• Visit Caps: Many plans limit the number of therapy sessions per year, regardless of your progress or needs.

Why Private Pay May Be Right for You

Private pay physical therapy eliminates these barriers, offering:

• Direct Access: Start care immediately without waiting for approvals.
• Personalized Treatment: Your goals, your plan—no compromises.
• Better Outcomes: Research shows one-on-one care with consistency in providers leads to quicker recovery and greater satisfaction.

Let’s Crunch the Numbers

Imagine you have a $3,000 deductible and need 10 PT visits at an in network clinic charging $250 per session:

• You’ll pay $2,500 out of pocket until your deductible is met.

Now compare that to private pay:

• At Impact Performance we offer package rates, like $1,550 for 10 visits.
• You save $1,000 while receiving higher-quality, one-on-one care.
• Research suggests you typically require less visits in private practice. After performing our evaluation we may determine you need fewer visits. This is why we also offer a 6 visit package for $930. This option would save you time and a total of $1,570. 

Final Thoughts

We believe everyone deserves high-quality care without the limitations imposed by insurance companies. At Impact Performance Physical Therapy, we’re committed to delivering personalized, effective treatment to help you achieve your goals faster and with fewer visits.

If you’re ready to invest in a healthier you, contact us today for a complimentary consultation. Let’s create a plan that works for YOU—not your insurance company.

Still have questions?

We encourage you to call your insurance company and ask:

• What’s my deductible?
• What percentage of the total bill goes toward my deductible?- total cost or the insurer’s negotiated rate?
• Do I need prior authorization for therapy?
• Is there a cap on visits?
• Do you cover performance based services? For example,  pain that is only related to my particular recreational activity? 

The answers might surprise you, and we’re here to help you navigate those details.

Research That Supports Private Pay

• 2018 (JOSPT): Patients receiving private pay physical therapy reported faster recovery and greater satisfaction, with fewer visits than those in insurance-based models.
• 2019 (Journal of Sports Science & Medicine): Cash-based patients were more likely to meet long-term performance and wellness goals due to extended care options.
• 2021 (Healthcare Economics Review): Administrative costs tied to insurance billing can increase healthcare prices by up to 30%, a burden avoided with private pay.

Let’s work together to get you better, faster—on your terms.