Perfect 10.0 PT: A New Approach to Physical Therapy

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Perfect 10.0 PT operates as a mobile, cash-based physical therapy clinic, offering direct care without the involvement of insurance companies. By eliminating third-party payers, patients gain access to personalized care without the inflated costs or restrictions typically imposed by insurance policies. While this model may seem unfamiliar or even confusing at first, it offers several key advantages.

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Common Questions About Direct Care Physical Therapy:

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Understandably, many people have questions like:

• How does this model work?

• Why pay out-of-pocket for PT when you already pay for insurance?

• Is this approach legal and ethical?

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These are valid concerns. The truth is, in today’s healthcare system, paying a provider directly can lead to higher quality care and potentially even cost savings compared to going through insurance. Many patients unknowingly pay more through their insurance plans without realizing what they’re actually getting in return. So the real question becomes: which system is more ethical?

When visiting a physician, the first question is often, “What insurance do you have?” But insurance companies don’t provide treatment—healthcare professionals do. We need to shift our view: your therapist, doctor, or nurse is your provider; your insurance is simply a financial tool. Unfortunately, that tool is becoming increasingly ineffective. Clinics like Perfect 10.0 PT are working to reshape that outdated model.

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Why Pay Directly for Physical Therapy?

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Think about these questions:

• What is your health worth to you?

• Is pain limiting your son/daughter to perform gymnastics skills or participate in competition?

• Do you want your insurance company determining your treatment plan?

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Using traditional insurance, patients often end up paying more than they realize. Thanks to recent price transparency regulations by the Centers for Medicare and Medicaid Services (CMS), patients can now see the costs of services upfront, before treatment begins.

To put things in perspective, in 2020, the average monthly premium was $456 for an individual and $1,152 for a family. Deductibles were also high—$4,364 for individual coverage and $8,439 for families. That means someone could spend over $4,000 out-of-pocket for physical therapy before insurance even covers a dime. That’s a major expense many don’t fully realize.

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The Reality of Insurance-Based Care

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In my eight years as a physical therapist, I’ve seen a steady increase in pressure to prioritize billing over patient care. Insurance reimbursement continues to drop, yet expectations rise. For example, a 45-minute session in a traditional clinic translates to just three billable units of time, which can technically stretch up to 52 minutes. But because appointments are often scheduled back-to-back (or double, triple, quadruple booked), PTs are encouraged to stop at 38 minutes, using the remaining time for documentation, cleaning, and meeting insurance requirements. This means patients may lose out on up to 14 minutes of direct care.

Add in rising co-pays—ranging anywhere from $10 to over $180 per visit (with some patients seeing bills as high as $500)—and the cost for a typical 12-visit PT plan could range from an extra $120 to $1,200. That’s a significant and often unexpected financial burden.

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The Advantages of Direct Care PT

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As a physical therapist who truly cares about patient outcomes, my top priority is to deliver high-quality, effective care. Insurance guidelines often interfere with that mission, placing limits on time, techniques, and frequency of visits. Without those restrictions, I’m free to develop strong, collaborative relationships with my patients and tailor treatment to their specific needs—resulting in more efficient and empowering outcomes.

Direct care allows your provider to focus solely on you; not paperwork, billing codes, or insurance policies. It’s a return to patient-centered care, where the goal is true healing, not just fulfilling administrative requirements.

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Direct Resources: Nault, Rebecca, website: MKE Physical Therapy: https://www.mkephysicaltherapy.com/why-would-you-pay-cash-for-physical-therapy/, accessed: March 5, 2024

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