I am an Out-of-Network provider with all commercial insurance companies including Medicare Advantage plans and Supplemental Medicare Plans. I am contracted with 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.

Why choose me as your provider? 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. Additionally, I offer holistic, trauma informed, and individualized care that is not dictated by your insurance company or 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 aren’t rushed. I work with one patient at a time for the entire appointment.

Discounted Time-of-Service Treatment Rates:

Initial Evaluation: $250

Follow-up Visits: $200

If you would like to submit an out-of-network claim to your health insurance company, I can provide you a superbill (a detailed receipt) upon request, to submit to your insurance company for potential reimbursement. Reimbursement depends on your specific plan benefits. If you would like an estimate on what your insurance plan will reimburse you, I recommend you contact your insurance company directly. Consider downloading our insurance worksheetto guide you through this process.

**If you have an a Medicare plan (Part B Medicare, Supplemental Medicare or Medicare Advantage plan), please reference the Medicare Physical Therapy Patients Tab Below, for additional information about billing procedures.

There are 3 types of Medicare Insurance Plans that cover Outpatient Physical Therapy Services: Part B Medicare (a government plan), Medicare Advantage (a commercial plan) and Supplemental Medicare plans (also a commercial plan).

I am out-of-network with Medicare Advantage and Supplemental Medicare Plans. However, I am contracted with Part B Medicare Plans as a Non-Participating Medicare Provider.

Part B Medicare plans are governed by the Center for Medicare Services (CMS). Unlike commercial health insurance companies, 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.

Regardless of what type of Medicare Plan you have, 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:

Initial Evaluation:$190-250

Follow-up Visit: $155 - 225

*Treatment rates for Medicare patients are based on the Center for Medicare Services Limiting Charge Fees. Treatment rates vary based on length of appointment and which CPT codes are billed. Extended visit rates for Medicare Patients are available upon request.

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. If you have a Supplemental Plan in addition to your Part B Medicare Plan, Medicare will submit the claim to your supplemental plan after Medicare processes your claim. Please note, I 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, I recommend you contact your insurance company directly. Consider downloading our insurance worksheet to guide you through this process.

• 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.