Frequently Asked Questions

No. In the state of Massachusetts Physical Therapists have direct access and can evaluate and treat you. However, we do communicate with your physician regularly to update them on your progress and send periodic progress reports.

Payment Options

Strength & Balance Physical Therapy LLC is an approved Medicare provider and an out-of-
network provider with all other payors. We accept cash, checks and credit cards for direct
payments to us.

Our fee for evaluations varies from $250 to $500 depending on the complexity of your physical
challenges and the length of time it takes to complete a thorough initial assessment. Ongoing
treatment is $185 per 50-minute session with 10 minutes allotted for follow up with family
members and caregivers. We will provide you with a fully coded superbill as a receipt but can

make no representation whether you will be reimbursed in part or in full should you use it to
submit to your carrier. We are able to offer prompt pay discounts, prepay discounts, and on a case-by-case basis,partial financial hardship waivers. Please reach out to us directly and in confidence at mckenzie@strengthandbalancept.com to discuss.

Additionally we are available to consult with family members about follow up suggestions,
training etc. either in person or via video conferencing.

Using Network Gap Exceptions and Single Case Agreements for Payment
If you are unable to find a suitable in network physical therapist available to work with you, it is
possible Strength & Balance Physical Therapy LLC might be able to work with you under a
Network Gap Exception (AKA Single Case Agreement or Network Deficiency Coverage). This is
a tool health insurance companies use to compensate for gaps in their networks of contracted
healthcare providers and the first step is to find out whether your carrier offers this. If your
carrier will grant you one, it usually only covers one specific service for a specified time period.
We will work with you to fill out the required forms to get approval and then may be able to be
paid directly by your carrier.

Using Flexible Spending Account and Health Savings Account for Payment
The good news is that according to the IRS Pub 502, physical therapy services are eligible for
reimbursement from flexible spending accounts (FSA), health saving accounts (HSA), health
reimbursement accounts (HRA), dependent care flexible spending accounts (DCESA) and
limited care flexible spending accounts (LCFSA). This means that you will be able to submit our
bills for reimbursement, and in many cases, we may be able to get paid directly from your FSA
or HAS.

We are considered an out of network (OON) provider meaning that we do not contract directly with any insurance company except for Medicare. We will provide you with a paid bill that you can submit to your carrier for potential partial or full reimbursement. Your amount of potential coverage depends on the terms of your individual policy.
We feel like there are distinct benefits to working with an OON provider. Our decision not to accept insurance stems from our commitment to practice with integrity and preserve the quality of care provided. Insurance companies operate on a medical model, always requiring a medical diagnosis/illness to establish you have a “medical necessity” to seek services and in order for them to pay providers. We feel like it is most important to decide what is the best therapeutic approaches to meet your goals, and together be the ones involved in the decision about the type, frequency and length of your care. We do provide out of network insurance superbills with all necessary codes to submit for potential partial or full reimbursement but make no representation that you will be reimbursed.