Before your deductible is reached, the fee schedule charged by a PT clinic versus the rate your insurance has contracted to pay them can be different. PT clinics charge high rates due to the deductions they take from preferred provider agreements and accepting federal insurance carriers (Medicare/Medicaid/TriCare/etc). Private insurance carriers pay the most based off this system due to the higher reimbursement rates of their insurance providers. Until your deductible is met, each session in Alaska is on average between $200-$300 (initial evaluations are higher) and this is not including copay costs.
Here is what we suggest you ask your insurance provider in order to educate yourself on your PT health care options.
- Ask your health insurance provider what the percentage total of your PT bill you will be required to pay at an in-network clinic (pre and post reaching your deductible).
- Call in-network PT clinics and ask what the average amount they bill to your insurance company so you know what your costs will be until you reach your deductible.
- Ask the PT clinics what your co-pay will be or look at your co-insurance costs for when you reach your deductible. Then ask how many times per week the average patient is advised to come in for treatment.
- Inquire about the duration of treatments and who will be treating you. One-on-one or multiple patients in the allotted time? Will you work with the PT (masters and doctorate level degrees) or will you be seen by techs and PTAs (tech-high school or PTA-associate’s level education requirements)?
- Determine how much work you will miss and how much time/money outside of treatment costs you will be investing in your care.
Once you add up the numbers, you may be surprised at how much cheaper and practical our clinic set up is for you. As stated before, we offer an insurance benefits worksheet to help you navigate filing self claims.
*We are an out-of-network clinic so be sure to ask your insurance provider if you have combined deductibles or separate categories for in-network and out-of-network costs.