The Financials

We understand that navigating payment for physical therapy services for your child can feel overwhelming, which is why we strive to make physical therapy as accessible as possible. We are in-network for some insurance plans, and we are out-of-network with other plans. While insurance can ease financial burdens, it often comes with limitations that affect the quality and depth of care. Your insurance may limit the number of sessions or types of therapy they deem “medically necessary.” By paying privately you have the freedom to select a therapist who aligns with your child’s unique needs and goals, without restrictions of an insurance network. This allows for a more personalized and meaningful connection that can enhance your child’s experience. At Blue Tang Physical Therapy we are committed to offering your child the best personalized care, whether through in-network, out-of-network or private pay.

How to Check Out-of-Network Benefits:

* Have Your Info Ready: Before calling your insurance company, have your member ID. It is helpful to have your insurance card available for reference. You will likely need to provide your child’s name and date of birth.

* Keep a Record: Write down the number you called, the representative's name, the date, and any notes or reference numbers from the call.
 

* Get a Live Representative: Choose the option for benefits or eligibility for "Medical" plans and try to speak with a live representative. Sometimes with voice prompts repeating the word “Representative” helps.
 

* Ask about Out-of-Network Benefits: Let the rep know you are “seeking out-of-network Medical benefits for outpatient physical therapy services” for your child. These benefits should be under your medical insurance plan.
 

* Provider Credentials: If asked, you can inform them that your provider is a DPT, PT (Licensed Physical Therapist). 

* Check Coverage Codes: Ask if the following procedure codes are covered under your out-of-network benefits:

 (These codes may be used for your child’s first visit)

97161 

97162

97163

(The following codes are commonly used for treatment sessions:)

97110 

97140

97112

97530


Reimbursement Process: Find out what steps are needed to get reimbursed. Ask if you'll need to submit a form, letter, or receipt, where to send it, and how long you have to submit (typically 90-365 days). This is called a "Superbill".
 

Payment: Clarify that you will pay the provider upfront for each visit and confirm that reimbursement will be sent directly to you, not the provider.

Out of Pocket Fees:

Current Rates for Blue Tang Physical Therapy services: 

$250 for evaluation  

$250 for 45-55 min treatment session 

We accept cash, check and all major credit cards. 

If payment for services are received on the day of visit a discount of $25 will be applied.  Any outstanding balances over 30 days will incur a 10% late fee and subject to possible delay in services. All bounced checks will incur a $30 fee.

Please call us with any questions!