Sorry, but I do not take Medicare, Medicaid, or MassHealth, even if you have gap insurance or supplemental policies. This does not mean we can’t work together, although special conditions apply. This section provides explanation of the regulations which constrain all private pay physical therapists.

 

If you are a Medicare beneficiary, please be aware that current Medicare law prohibits you from privately paying for physical therapy services which they usually cover.  Medicare’s  rule is this:

 

• You may not pay privately for services that are covered by Medicare. Since Medicare covers physical therapy that is medically necessary, such as for pain or functional impairment, Medicare requires that you receive physical therapy for covered (medically necessary) services from a Medicare participating provider, even if you want to go to someone else.  

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• Medicare does not cover Preventative care, Wellness education, or Fitness services (these are not consider medically necessary, and are non-covered services by Medicare). Therefore Medicare will allow you to pay out of pocket for these services. Since prevention and wellness education are services that I very often provide anyway, we may enter into this relationship together on a private pay basis, but I would not be able to charge you for treatment of pain or functional impairment.

 

In summary:    

• I may not charge you to treat pain, injury, or functional impairment. 

• I may charge for preventative care, Wellness education, or fitness services.

 

If you have concerns regarding the ethics of this Medicare law you may learn more about The Medicare Patient Empowerment Act of 2013)— - See more at: http://www.webpt.com/blog/post/should-physical-therapists-enroll-medicare-providers#sthash.QhD1PrQL.dpuf

 

If you have Medicare and have weighed your options  and you still really wish to see me for private pay services, please call me and we can talk about it in more detail. (413) 544-4409