TRANSPARENT BILLING
Understanding Your Coverage
At Bobby Geevarughese Physical Therapy, PLLC I believe that understanding your financial investment is a key part of the recovery process. I have designed my payment models to be straightforward so you can focus on retraining your nervous system and reclaiming your life..
Medicare Acceptance
I am pleased to share that I directly accept Medicare. If you are a beneficiary, telehealth physical therapy is a covered benefit. Please provide your insurance card at booking so I can coordinate your coverage and verify your plan details.
Out-of-Network Care
I am a private-pay clinic that works outside of traditional insurance contracts. This choice allows me to provide undivided 1:1 attention and expert-level care that is not restricted by strict insurance protocols, ensuring you get the recovery results you deserve.
The Superbill Process
For our out-of-network patients, I issue a monthly Superbill. This provides all the medical codes required by insurance for reimbursement. I find that many patients with out-of-network benefits receive a significant portion of their visit costs back directly from their provider.
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***Please remember that each plan is different and reimbursement is based on what the insurance company determines they will pay for the treatment.
Insurance & Payment FAQs
How do I check my coverage?
Contact the member services number on your insurance card and inquire about 'out-of-network benefits' for telehealth physical therapy. Here are some questions to ask below:
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What is my out-of-network deductible and has it been met?
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How many sessions per year does my health insurance cover?
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What is my out-of-network coinsurance for outpatient physical therapy visits
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What is the allowed amount per therapy session? What percentage of the fee is covered?
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You can provide them with the CPT* codes for the initial appointment 97161 and 97110 for therapeutic exercise, 97112 for Neuromuscular re-education, 97530 for Therapeutic activities, 97116 for gait training, and 97535 for self-care.
*CPT stands for Current Procedural Terminology and refers to the type of treatment you are receiving.
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Are virtual outpatient physical therapy visits covered by my plan?
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Is a referral required from an in-network provider or a primary care physician to see someone out-of-network?
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Can I see a Physical Therapist through Direct Access? (More information on Direct Access located at the bottom of the page)
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Do I need pre-certification to use my out-of-network physical therapy benefits?​
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​How do I submit claims for out-of-network reimbursement?
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Can I use a health savings account?
Yes, I accept HSA and FSA accounts. You can pay out of pocket and I will give you a Superbill you can use for reimbursement to your plan.
What if I am out-of-state?
Clinical PT is available for residents of NY and NJ. For those globally, I offer pain coaching that focuses on neuroplasticity and recovery through a non-medical approach.
Have more questions?
I am dedicated to being your partner on this recovery path. If you have any further questions about payments or billing, please reach out directly.
Out-of-Network Specialists
I have chosen to remain an out-of-network provider to ensure that your recovery is guided by your needs, not by insurance company restrictions. In the traditional insurance model, therapists are often limited by the number of sessions, specific body parts they can treat, or the time they can spend with you.
Being out-of-network allows me to provide higher quality, one-on-one telehealth care. This means longer sessions, faster healing, and a focus on the Mind Body connection that is essential for chronic pain recovery. While I do not bill insurance directly, I am committed to making the financial side of your care as transparent as possible.
What this means for you:
- Transparent Pricing: You pay a flat rate at the time of service.
- Personalized Care: No arbitrary limits on the number of sessions.
- Ease of Access: Quick scheduling and consistent care with the same therapist.
Medicare Information
I am pleased to accept Medicare Part B for telehealth physical therapy services. For those with Medicare coverage, your sessions may be fully or partially covered depending on your specific plan and supplemental insurance. Please note that a physician referral is typically required for Medicare billing purposes. I am happy to help you navigate these requirements during your initial intake.
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Automatic Generation
At the end of every month, I prepare a detailed superbill that includes all necessary clinical codes and session information.
Reimbursement Made Simple
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Submit to Insurance
Upload your superbill directly to your insurance provider's online portal or mail it using their standard reimbursement form.
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Receive Funds
Your insurance company will process the claim and send reimbursement directly to you based on your out-of-network benefits.
Direct Access
Available to residents of NY and NJ. May be seen by a Physical Therapist without a physician’s referral for 10 visits or 30 days. Please check with your insurance company for coverage.
Sliding Scale/ Reduced Fees
Sliding scale fees available on a limited basis to make treatment more affordable for those in financial need. Service is provided on a time limited basis. Please reach out to discuss.