Cash-based physical therapy, sometimes called self-pay or out-of-network physical therapy, means the clinic does not directly accept insurance. Instead, patients pay the clinic for their care.
At Art of Physical Therapy, we accept major credit cards, cash, and HSA/FSA payments. Depending on your needs, you can pay per visit or use one of our packages if we determine that several visits would be appropriate.
But how you pay for physical therapy isn't the main reason we chose this model.
The biggest difference for us is the freedom it gives us to treat the person in front of us without allowing insurance restrictions to dictate the plan of care.
We can look at how your whole body moves, spend time understanding what you want to get back to doing, and adjust treatment as your needs change.
That's important because your goal probably isn't simply to make your knee, shoulder, or back hurt less.
You want to get back to doing something.
Why We Chose a Cash-Based Physical Therapy Model
Insurance can be helpful, but it can also place restrictions on physical therapy. Depending on the plan, there may be limitations involving the body region being treated, number of visits, authorization requirements, or covered interventions.
We didn't want those restrictions determining how we treated our patients.
Let's say you originally come to Art of Physical Therapy because your knee hurts.
We work on the problem and your knee starts feeling better. That's great, but now you tell us what you really want is to get back on the pickleball court without worrying about hurting it again.
We don't believe treatment needs to stop simply because the original pain has improved.
Your plan can change with you.
We may transition from treating the injury into sports performance, where the focus shifts toward strength, movement, performance, and reducing the risk of reinjury.
The same thing happens when another problem comes up during treatment.
Patients sometimes tell us about another nagging issue during their initial evaluation, or something new develops while we're working together. Because we're not waiting on an insurance company to authorize treatment for another body region, we can evaluate what's happening and determine whether it should be addressed.
Sometimes dealing with a problem early prevents it from becoming a much bigger issue.
What Does One-on-One Physical Therapy Actually Look Like?
Most appointments at Art of Physical Therapy are 60 minutes.
That time is spent one-on-one with a Doctor of Physical Therapy.
We're not bouncing back and forth between several patients. You're not spending part of your appointment working with a technician while your physical therapist treats someone else.
That hour gives us time to:
Assess how you're feeling and moving that day
Progress or modify exercises
Provide hands-on treatment when appropriate
Work on specific movement limitations
Update your home exercise program
Answer questions
Explain why we're making changes to your treatment
Keep the plan focused on your goals
We also offer 30-minute follow-up maintenance visits. Some patients use these after their pain has resolved because they want to continue working on movement, performance, or staying ahead of recurring problems.
We Don't Just Look at Where It Hurts
One of the biggest parts of our approach is the evaluation.
We take a full-body, holistic approach because the place where you feel pain isn't always the only area that needs attention.
You might come to us because your shoulder hurts.
During the evaluation, we may find that your neck mobility is limited and contributing to what you're feeling in your shoulder.
If we only focus on the shoulder because that's where the pain is, we may miss an important part of the problem.
That's why our motto at Art of Physical Therapy is:
Mastering Movement, Maximizing Performance.
We want to know how you move, where you're limited, and what needs to improve so you can get back to the activities that matter to you.
"Performance" doesn't only mean competitive sports.
It could mean running a race, swimming, practicing yoga, playing pickleball, training in the gym, keeping up with your kids, or simply getting through your day without constantly thinking about pain.
We want you to be able to do what you enjoy and do it well.
How Is One-on-One Physical Therapy Different From a Traditional Insurance-Based Clinic?
Not every insurance-based physical therapy clinic operates the same way, and there are excellent physical therapists working in traditional settings.
The difference we can speak to is how we've chosen to structure care at Art of Physical Therapy.
In some clinics, appointments may involve a physical therapist, physical therapist assistant, or technician. A physical therapist may also be responsible for more than one patient during the same treatment period.
At Art of Physical Therapy, your appointment is one-on-one with a Doctor of Physical Therapy.
That dedicated time matters to us.
If an exercise isn't working well that day, we can change it.
If your symptoms have changed, we can reassess.
If you're having trouble understanding an exercise, we have time to work through it with you.
If you've progressed faster than expected, we don't have to keep doing the same program simply because that's what was originally planned.
Physical therapy shouldn't feel like following a worksheet.
Your program should change as you change.
Is Cash-Based Physical Therapy More Expensive?
This is one of the first questions people have, and it's a fair one.
Cash-based physical therapy can cost more per appointment than an insurance copay.
For example, someone might pay a $75 copay at an in-network clinic compared with $175 for a 60-minute one-on-one appointment at Art of Physical Therapy.
Looking only at those two numbers doesn't tell the entire story.
What are you receiving during that appointment?
Our goal is to make each session count. We have a full hour to work directly with you, modify your program, provide hands-on care when needed, educate you, and make sure you know what to work on between visits.
Many of our patients are seen once per week rather than two or three times per week.
We also give patients an individualized home exercise program. When those exercises are performed consistently, often three to four times per week depending on the plan, treatment continues outside the clinic.
We don't believe cash-based physical therapy is automatically the right financial choice for everyone.
We do believe patients should understand what they're paying for and compare the entire plan of care, not just the price of a single appointment.
A Patient's Experience With One-on-One Care
One patient came to us after seeing several other physical therapists and chiropractors.
She told us she noticed the biggest change in her pain after coming to Art of Physical Therapy.
What stood out to her wasn't a fancy piece of equipment or one particular exercise.
It was the time and attention.
She felt like we listened to her and built the treatment plan around what she actually needed.
There were also times when the original plan needed to change.
Instead of continuing with the same exercises because they were already on the program, we modified what we were doing and explained why.
She appreciated understanding the reasoning behind those changes.
That's something we take seriously.
We don't want patients blindly following exercises. We want you to understand what we're working on, why we're working on it, and how it connects to what you want to accomplish.
Do I Need a Referral for Physical Therapy in North Carolina?
North Carolina allows direct access to physical therapy, which means most people can see a physical therapist without first getting a referral from a physician.
That can be particularly useful when an injury has just happened.
If you get hurt and we have an opening, we can often get you into the clinic within 24 hours rather than waiting to go through several steps before you can have the problem evaluated.
There can be individual circumstances where a referral or additional medical evaluation is appropriate. If we evaluate you and believe you need to see another healthcare provider, we'll tell you.
Our job isn't to keep every patient in physical therapy.
Our job is to help you figure out the right next step.
Who Is a Good Fit for Cash-Based Physical Therapy?
We work with athletes of all ages, active adults, and busy professionals.
Cash-based, one-on-one care may be a good fit if you:
Have an injury that keeps interfering with an activity you enjoy
Want to return to a sport after an injury
Have a recurring problem that hasn't been fully resolved
Want more individualized attention during physical therapy
Want to improve movement or performance after the pain is gone
Are trying to avoid surgery when conservative treatment is appropriate
Want to understand why something hurts instead of only managing the symptoms
You don't have to be a competitive athlete.
Being active means different things to different people, and your goals should reflect what matters in your life.
Our Physical Therapists Bring Different Experience to Your Care
Our treatment approach is also shaped by the backgrounds of our physical therapists.
Ranndi Bitner, PT, DPT
Ranndi is certified in dry needling, which may be used when appropriate to address trigger points associated with musculoskeletal problems.
She is also FMS certified. The Functional Movement Screen looks at movement patterns and can help identify mobility and stability limitations.
We can use information from movement screening alongside our initial evaluation to get a better picture of how someone moves rather than focusing only on the painful area.
Ranndi especially enjoys working with swimmers.
She was a Division I swimmer at Liberty University, so she understands the sport from both sides. She knows what training looks like in the weight room and what athletes experience on the pool deck.
That experience influences the way she evaluates and treats swimmers today.
Daniel Hines, PT, DPT
Daniel particularly enjoys working with runners.
His background includes run club leadership at Elon University, participation in running-related research, and training in 2D running gait analysis.
Daniel is also a Board Certified Orthopedic Clinical Specialist (OCS). His orthopedic residency training provided advanced education and clinical experience involving the prevention, evaluation, and treatment of musculoskeletal conditions and their related neurovascular components.
That background can be especially valuable when we're trying to understand why an injury keeps happening and what someone needs to safely return to running or another activity.
What If I'm Not Sure Cash-Based Physical Therapy Is Right for Me?
You don't have to figure that out by yourself.
Art of Physical Therapy offers a free discovery call.
We can talk about what's bothering you, what you've already tried, what you want to accomplish, and whether our approach makes sense for your situation.
Ask questions.
We want you to understand how our clinic works before deciding whether we're the right fit.
If you're hesitant but ready to start addressing the problem, an initial evaluation can also give you useful information right away.
During that first visit, we can evaluate how you're moving, discuss what may be contributing to the problem, establish a plan, teach you ways to manage your symptoms outside the clinic, and give you a home exercise program so you can begin working on the problem from day one.
Cash-Based Physical Therapy Is About More Than Getting Out of Pain
Pain may be what brings you through the door, but we don't want that to be the only thing we address.
We want to understand the whole person.
What do you want to get back to?
Where are you having trouble moving?
What keeps happening when you run, swim, lift, work, or play your sport?
What needs to change so you aren't back in the same situation a few months from now?
Cash-based physical therapy gives us the freedom and time to ask those questions and build your care around the answers.
For us, that's the real value of one-on-one physical therapy.
It's not simply about managing a symptom.
It's about helping you move better, return to the things that matter to you, and be the best you can be.
