Why Cash Based Physical Therapy is the NEW Wave of Physical Therapy in 2022

Cash based physical therapy is emerging as one of the best options you not only for rehabilitation from an injury but also to manage chronic conditions like osteoarthritis. This model operates outside of the insurance world. This allows for a completely different approach to your pain because we get it, pain can be scary. Having someone you can trust and easily access is so important to your long term success. Instead of just “fixing pain” and feeling like another name on someone’s schedule, in this cash based model you gain a friend that is there with you along your journey.

Let me tell you a story of the power of cash based physical therapy.

I had a client who had never really been in a consistent exercise routine. He started developing knee pain as well as disabling back spasms. He was recommended by a functional medicine doctor, a great option for medical care that truly helps to look at the full picture. He was tired of pain and wanted to do something about it.

I showed up at his house for our appointment and ended up showing up many more times. He was finally feeling pain relief and staying accountable because he knew I was coming. After each visit he would have workouts to complete with videos, instead of just a piece of paper of exercises.

He was doing so well and was not experiencing any pain! He was staying consistent with the workouts for the next 4-5 months. Then he sends me a message stating he had begun falling off of the wagon due to vacations and family visiting the previous weeks and wanted to get back on.

I saw him that week and now we are back on track! Could you do that with a traditional physical therapist? Likely not as most of the time, you have to see your family doctor first and go through the trouble of getting a new prescription.

I totally get it, the journey to pain relief is not easy. It can be hard to stay consistent. You need someone in your corner, keeping you on track. That is what we can offer, especially if you are dealing with a condition without a cure such as osteoarthritis.

Here are a few other accounts of how powerful cash based physical therapy can be!

“I feel like you actually care. Before I always went to different therapists in big clinics and never really got to know them. I feel like I wasn’t understood because I didn’t have enough time to tell my story. It felt like it was always just in and out. To me, it feels like we are friends!”

“I never really had luck going to physical therapy before. I mean it was okay and I would have some success but I never reached the full potential that I wanted to. There were many times when I would be with a new therapist during my appointments which was hard, re-explaining my story all the time. I know that I can just call or text you and you can get me right on the schedule!”

“I have never tried traditional therapy using my insurance but now that I know this is an option, I’m not sure I ever will. I love all of the videos you send me for exercises and that I can ask you questions at any time just by texting! It gives me so much more confidence and reassurance. Many times if I have questions I never have time to ask my doctor. Now, you make it so easy by answering all of my questions!”

These are actual patient testimonials after working with them in a cash based model.

So what are the benefits of cash based physical therapy?

This is a very common question when speaking with clients so I want to explain the benefits of seeking out a cash based physical therapy service over a traditional in-network insurance provider.

I have worked in corporate healthcare for years and it definitely has it’s time and place. This article is not to say that you should never use your health insurance again. Everyone’s situation is different. I just want to open your eyes to a fresh new perspective that is now emerging to the new normal. This model works particularly great for those who may not have seen success in a traditional physical therapy clinic or who wants continued accountability after the 4-8 weeks they spend in the traditional clinic.

Here at Keep the Adventure Alive, we are an out of network provider for all insurances meaning we do not bill your insurance company for our services and the fees are paid up front. This is actually becoming very common for both physical therapists and other health care professionals, and we would love to explain the great benefits of it.

Why it can trump insurance

1. It allows us to offer you a premium service. Without going through insurance we have less paperwork (meaning our head won’t be in the computer the entire session) and we are not dictated by how many visits your insurance deems as appropriate.

Let’s look at this example:

Do you have Amazon Prime? Why do you pay extra for Amazon Prime? You could purchase the same products through regular Amazon and just wait a few extra days for delivery compared to Prime. We purchase Prime because it’s a premium service which delivers our packages in two days along with having access to additional add-ons not included with normal Amazon orders. Most people would say they could never live without Prime. Amazon has provided a premium service worth the money.

A few other examples:

Do you pay for HBO or Netflix on top of your cable bill? You already have cable so why would you need to pay an additional monthly fee? Because they have much better content compared to regular TV. Again, it’s a luxury and we pay to have the premium service. 

What about the hair salon (maybe more for the ladies out there:)? Many times, we choose to go to the nicer salon that has more amenities, offers a more intimate service, and has a better atmosphere than a lower ticketed, walk in salon. Again, we choose to pay more for this service even though there are cheaper options because we want a premium experience.

Think of physical therapy this way too. If you pay cash, you are able to receive a premium service. Do you want the basic service or do you want the more intimate experience? Insurance will pay for the basic service. Your health is one of the most important things we have in this life. You are worth the premium experience. With cash based, we are able to take the time to learn about you and get you past just walking around your home. We want to get you back to mountain biking, hiking, walking- whatever your adventure is.

“But I pay into my insurance every month, I want to use it”

This is a fair point. Think about all of the other things you use insurance for. Doctor’s visits, trips to urgent care, wellness visits, unexpected broken bones, etc. Co-pays can end up being much more expensive than we anticipate and often times we get surprise bills at the end of traditional physical therapy because the insurance didn’t cover certain codes or treatments which can be very frustrating! Cash based physical therapy is always a flat fee, you know what you are paying with no surprise bills.

2. You don’t need to see your physician first when you are working with someone in cash based physical therapy.

Look at these 2 scenarios.

Scenario 1: Say you are 55 and you start to gradually have knee pain after you walk or run a certain distance, without any injury. You are thinking about going to physical therapy but in order to get referred, you need to see your physician first.

  • For physician visits say your co-pay is $50. You can get in to see your physician in 2 weeks. So, you deal with this pain, it starts to get worse and you finally see the physician.
  • He recommends you get an x-ray- which costs $80 through your insurance. The image shows everything looks okay, but you might be having some arthritic changes.
  • Now you finally have a referral to physical therapy and your co pay is $45, to be paid at each visit. They want to see you 2 times per week for at least 8 weeks because that’s what your insurance covers. You now have to drive to clinic twice a week and pay almost $50 every time. 16 visits x $45 is $720. 
  • At the end of the 8 weeks you have a piece of paper of exercises that then collects dust on your kitchen table and your knee pain begins to come back 2 months later and you’ve spent $850.

Scenario 2: You gradually start to notice knee pain while you are walking or running a certain distance, without an injury.

  • You know a cash based physical therapist and don’t want to deal with getting a referral from a physician so you come see Alyssa who is a doctor of physical therapy.
  • She rules out all signs of serious injury or signs of any tears. She knows we can treat this conservatively i.e. with appropriate exercise, strengthening, and cleaning up some of your movement patterns. 
  • Alyssa sees you once per week for 5 weeks for $125/visit in your home and gives you exercises with video instruction for you to follow the rest of the week and she follows up with you a few days later to make sure you’re on track.
  • At the end of the 5 weeks, you now know what exercises you should continue to add to your routine and have the resources to make sure your knee pain doesn’t come back because you were very consistent with your training those 5 weeks. 
  • You’ve spent $625 and now are pain free. 

See the difference?

Other benefits of cash based physical therapy

We can address multiple issues you might be having at once, say for example you are having knee pain and start to have shoulder pain a few days later from carrying your grandchild all weekend long. Seeing a cash provider we can tackle both at once! Seeing a traditional physical therapist, you now have to see your physician again to get a referral for your shoulder now.

You have skin in the game. Let’s be real, motivation can be tough and consistency is one of the hardest parts of making changes to your pain. You have to be consistent. It is easy to slack off if you know you aren’t paying for something, or paying very little. There’s not much to lose. BUT if you are invested in something and you know the money is coming out of your pocket, you are much more inclined to actually do it.

For example, let’s look at Planet Fitness- $10/month versus a premium gym that charges $200/month. If you slack off a month or three at planet fitness you are only losing $30 so it’s not very motivating to go. But if you are paying $200 you know that you are going to make it at least a few times per week so you get your money’s worth! Guess who makes more progress?

Long term relationship with your physical therapist. Say you see Alyssa for knee pain related to arthritis and now that is under control. A few months later you end up hurting your ankle hiking. Instead of having to go to your physician you just text Alyssa and she comes to see you the next day, saying you don’t need an x-ray after doing some tests and gives you some exercises to do. Then a month later you trip over something in your kitchen and hit your shoulder on the door. You call Alyssa and she comes over, and helps you heal your shoulder for 3 visits. Easy peasy! 

I know that physical therapy does not work for everyone, it’s not perfect. There are a few reasons that you may have some control over, especially if you are dealing with osteoarthritis. Take a look at the video below:

Cash based physical therapy is an option for you if you have an injury or are tired of nagging aches and pains. We have worked with clients near Sandy, Utah with this model and our patients are nothing short of impressed with their results. We would love to finally get you to where you want to be.


Dr. Alyssa Kuhn is a doctor of physical therapy and arthritis specialist based in Sandy, UT. She is on a mission to help you find hope within arthritis and get your life back while breaking free from the pain without pain pills or surgeries. She has helped countless people across the country find relief from arthritis pain and stop wasting time and money on temporary or ineffective treatments. Join our FREE facebook community for more support and motivation!

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