Insurance

Insurance & Payment Options

Our Approach to Insurance

At Austin Physical Therapy, we have worked for over a decade to utilize the best practices in physical therapy here in Austin with the goal of providing the most comprehensive and individualized care. We also want to work with our patients, athletes and families to be cost effective and conscious of health care. As a result, we are a hybrid clinic, which means we will work with your insurance first. We are in network with some plans. Others will be out of network, and we have successfully filed and collected from your insurance company using both options. We also have a cash pay option.

Please note you will be responsible for your allowables per your in-network insurance plan.

In-Network Insurance

We bill your insurance directly for your convenience. You will be responsible for charges not covered by your carrier according to your contract, including:

• Co-Payments: Collected at each visit
• Co-Insurance: Billed and collected after your insurance determines coverage (typically 10-30% based on your policy)
• Deductible: Billed and collected after your insurance determines coverage according to your benefits

We currently participate as in-network providers with BCBS and Medicare. This list may change, and we will notify you in advance if changes occur. At this time, other insurance carriers have reduced their reimbursement to levels that do not support the personalized and specialized care we provide.

Out-of-Network Insurance

We bill your insurance directly, and you will be responsible for charges not covered by your carrier up to a maximum of $150 per visit. Your financial responsibility primarily depends on your deductible and its remaining balance. We collect $150 at the time of service for patients with deductibles exceeding $1,500 unless we arrange alternative payment plans in advance.

If you are out of network at our clinic you will be responsible for each visit up to our cash rate of $150. If your insurance company covers that entire amount once your deductible is met, you will have no further responsibility for the visit.

Many of our patients receive care through out-of-network benefits with great success. Often, patients with low-deductible plans have less financial responsibility than some of our in-network patients. This arrangement allows us to provide care in a more specialized environment with more direct attention since we do not accept insurance companies offering inadequate reimbursement for physical therapy.

Your financial responsibility is between you and our clinic, but we strive to maximize your insurance benefits. You may receive an Explanation of Benefits (EOB) from your insurance company indicating a certain amount owed, but this is not a bill from our office.

Important: EPO and HMO Out-of-Network plans will not provide coverage for physical therapy services.

Cash-Based Services

You are responsible for the full cost of the visit. Our current cash rate is $150 per visit, collected at the time of service.

Insurance Verification

We have an insurance verification team that will thoroughly investigate your particular plan and provide you with a verification of benefits within 48 hours after receiving all of your insurance information. This helps us keep our physical therapists focused on providing you care and allows as much coverage as possible from your individual plan.

National Reach

We are fortunate to provide local coverage to patients who seek surgery from world-class orthopedic groups nationwide including the areas of:

• New York
• Manhattan
• Chicago
• Charlotte
• Marina Del Ray
• Santa Monica
• Dallas
• Ft Worth Houston
• Vail
• San Antonio
• Birmingham
• Clearwater
• And more

We can provide sports-specific testing and return to play guidelines that will help us directly communicate with your surgeon or surgical group, maintaining continuous quality care.

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining your medical care costs.

Under the law, health care providers must give patients without insurance or those not using insurance an estimate of expected costs for medical services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including related costs such as medical tests, prescription drugs, equipment, and hospital fees.

You may request a written Good Faith Estimate from your health care provider before or during your first visit.

Estimated Costs

• Cash-based physical therapy: $150 per visit
• Out-of-network physical therapy: Maximum of $150 per visit (may be less depending on your plan and deductible)
• In-network physical therapy: Based on your specific benefit plan
  • Medicare: 20% of billed charges (approximately $16-28 per visit unless you have secondary coverage)
  • BCBS: $99-180 per visit if there is no coverage due to unmet or high deductible

Taking the Next Step

Contact our insurance verification team today at (512) 985-2200 to discuss your specific coverage and start your path to recovery with a clear understanding of your financial options.