How much does physical therapy in Boise cost?

by Gavin Morrison on April 12, 2014

One of the most frequently asked questions I get from first time patients seeking physical therapy in Boise is “How much is therapy going to cost me?” The answer to that question is subject to the benefit details of your health insurance policy.

Paid cash

Physical therapy in Boise can cost anywhere from $0.00 to upwards of $2000.00. It all depends on your health insurance plan, if you have one and how long you will need therapy.

If you have no health insurance or have a large deductible ($2000 – $5000) most physical therapy clinics are willing to charge a reduced “cash rate” and forgo billing insurance altogether. This reduces the cost of your therapy from somewhere around $120 per visit to approximately $70-$80 per visit depending on the clinic. Our cash rate is $70 per visit. Physical therapy may be just a few sessions (3-4 visit) or as much as 2 sessions per week for 8 to 10 weeks (16 – 20 visits) sometimes more depending on the seriousness of your condition.

If you have a large deductible and elect to pay the cash rate the cost of the therapy is less but your payments do not count against your deductible. If you need medical care later in the year you will still need to meet your entire deductible before the insurance company pays for that care.

BCI

The cost of therapy with health insurance depends on the size of your annual deductible and the co-insurance or co-pays that your policy requires you to pay. Most individual health insurance plans have high deductibles. This means that the cost of therapy is not covered by insurance until the deductible is met. This could be anywhere from $2000 to $5000 depending on your policy. Once the deductible is met there is usually a co-insurance payment required for every visit. Co-insurance can range anywhere from 10% of the cost of each visit up to 70%. Most co-insurance is 20%. This means that you are required to pay 20% of the cost of each visit with the insurance company paying the other 80%. Calculating a 20% co-insurance payment also depends on a couple of factors. How long your appointment is and how much your insurance company allows for each visit. At my clinic, if you have an average insurance policy (20% co-insurance) the cost of a normal visit (1 hour) is around $120 which makes the co-insurance approximately ($120 x 20%) $24.00 per visit.

Some policies require a flat rate payment called a co-pay. The co-pay can range anywhere from $10 – $40 per visit regardless of how long your visit is or how much the cost of the visit is. Occasionally a policy will require a co-pay and co-insurance payments however these policies are rare.

Health insurance policies also have what is called a maximum out of packet limit. These limits can range from $1000 – $10,000. Once you’ve reached your maximum out of pocket limit by paying deductibles and/or co-insurance, the insurance company pays 100% of your medical bills until the end of the year or until your policy resets at the policy yearend. This comes into play if you’ve had a surgery or have already paid for a lot of other medical care prior to starting therapy.

Most policies have a maximum limit that they will pay for physical therapy during the year. This can be a dollar amount or a certain number of visits. It can range anywhere from $500 (approx. 4 visits) up to $6000 or 50 visits. Once the therapy maximum is reached, the insurance company stops paying and you are be required to pay for any remaining therapy visits out of pocket. At our clinic after a patient reaches their maximum therapy limit we only charge the reduced cash rate for the remaining visits.

The “policy yearend” is the point at which your annual deductible and max out of pocket re-set. This is usually Dec. 31st but it is sometimes June 31st depending on the policy. This comes into play if your therapy continues past your policy yearend, at which point you will have to start paying toward the deductible for the new year.

If patients have a large bill after therapy due to a high deductible or large co-insurance rates we offer monthly payment plans.

To find out the details of your policy before starting therapy you can calls us, give us your policy number and we can verify your benefits for you. That way we can give you an estimate of how much your therapy will cost per visit. You may also call your insurance company’s customer service department directly to find out all details yourself.

The important details are:

1) Your annual deductible

2) Your co-insurance rate or the amount of your co-pays

3) Your maximum therapy visit or dollar limit

4) Your policy year end date

If you would like us to verify your benefits and estimate your per visit cost call us at 208-608-0958.

If contact Blue Cross of Idaho for policy information visit their website at:

http://www.bcidaho.com/

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