The Cost of Physical Therapy
In today’s world of high deductibles and costly doctor’s visits, it can seem daunting to dip into your pocket for care, especially when you don’t know what to expect. In fact, one of the most common questions we receive from patients is, “How much does PT cost?”
Though the exact answer will vary based on your specific needs, the total cost for the average episode of care, or 10 visits, is $1,000.
Physical therapy is a cost-effective treatment designed to get you back on your feet quickly, and with lasting results. Not only do most insurance providers cover physical therapy, it has been proven to reduce medical costs by diminishing the need for unnecessary medication, imaging scans, or surgeries.
In fact, here’s how physical therapy stacks up compared to those other frequently prescribed interventions:
That’s a high-level cost breakdown of PT vs. other healthcare expenses frequently prescribed for those suffering from musculoskeletal conditions, but there are a few other factors to take into consideration, like:
Seeing your physical therapist first can reduce the total cost of care by 50%.
If you’re in pain, your first instinct is likely to pay a visit to your primary care physician, who may then refer you to an orthopaedic specialist, who will write you a prescription for physical therapy. In fact, a 2017 Merritt Hawkins study showed that the average wait time to see a physician is 24 days, up 30% from 2014.
That process alone can set you back a few insurance co-pays, not to mention a couple of weeks. Heading directly to your physical therapist saves money – the right physical therapy within 14 days of the onset of pain minimizes the average total cost of care by 50%. Low back pain patients who receive physical therapy immediately after the pain begins and adhere to their treatment plan spend $3,000 a year in associated healthcare costs. Those who delay receiving physical therapy and do not adhere to their treatment plan spend $6,000 per year on all kinds of healthcare.
Lastly, a 2015 Health Services Research study found that the average cost of care was shown to be $4,793 more if a patient had an MRI first vs. seeing a physical therapist first. The study also shows the increased use of other services like additional diagnostic imaging and medication when the MRI is done prior to physical therapy.
A study just published in the Journal of the American Board of Family Medicine found that the patients who were sent to a physical therapy consult were 35% less likely to be prescribed opioids, even if they didn’t keep up with physical therapy after the initial evaluation.
There’s a lot of compelling evidence that supports these points – if you’d like to see more, email us at [email protected], we’d be happy to show you!
Physical therapy at BreakThrough costs 44% less than the national average.
If you haven’t seen our scorecard yet, allow us to briefly brag on ourselves. According to data from the Workers’ Compensation Research Institute in 2015, the average cost per episode of care was $1,734 (including both patient and insurance responsibility). BTPT’s average cost per episode? $968. That’s 44% less than the national average.
If it didn’t work, insurance wouldn’t pay for it.
Look no further than Humana for proof. In December, they lifted their prior authorization requirement for outpatient physical therapy.
In layman’s terms, Humana has recognized that quick access to PT is important. As quick and fantastic as our care coordinators and front desk staff are, the authorization process can sometimes be a slow one. This is Humana’s way of eliminating the barrier that may be keeping you from getting in the door the moment you’re ready to see us.
All that considered, we understand that the cost of healthcare can sometimes seem unmanageable, especially when it’s unexpected. BreakThrough will work with you no matter your financial situation to ensure you get the care that you need.
Whether you have questions about your deductible or want to discuss private pay options, someone’s always available to talk! Our friendly, knowledgeable billing concierge can help. Contact Charlene Boulton – [email protected] or 919.377.8744.