October 22, 2020

Back to the Basics: Starting a Cash Practice

Are you intrigued by the idea of cash-based physical therapy but overwhelmed by the prospect of making it work?

Indeed, the thought of abandoning insurance and making the leap to a cash-based practice can be an unnerving one. Danny Matta, entrepreneur and expert on cash-based physical therapy writes: “After I decided to open my own practice, the questions really came down to one major question: insurance, or no insurance?”

After doing some research and speaking with his colleagues, the answer to this question became clear…

After all, do you really enjoy haggling with a third party over what you can and cannot do for your patients? In dealing with insurance companies, physical therapy practice owners often find themselves paid too little and pushed around, with reduced ability to deliver optimal treatment. What happens when you’re ready to move beyond “making it work” to running a profitable yet genuine business? Welp, you’ve got two sub-par options: increase the number of patients you’re seeing, or attempt to sell to a larger clinic that does have some amount of leverage. The second option is clearly not ideal, but neither is the first! Increasing the number of patients you’re seeing will likely reduce your capacity for quality care and result in burnout.
Danny writes, “I’ve worked in high-volume settings. I’ve had friends that hung in there at clinics seeing 30–40 people a day with just one tech to help for a year. I saw my same friend’s health deteriorate and his love for his profession disappear; eventually, he moved on to doing
home health PT.” Working with insurance too quickly becomes an exhausting job (with little return) in and of itself. Danny’s answer was clearly, “no insurance.” Yet, this presents an entirely new question: “If I don’t take insurance, will it work?”


The answer is “YES!” Why? Because there is demand. Just as you are burnt out from bending to the whims of insurance companies, many enthusiastic and active individuals are sick and tired of receiving the kind of care available through insurance coverage. Cash-based physical therapy allows you to work with the clients you would be unable to serve in an insurance-based practice through the provision of individually-tailored, high-quality care. See, cash-based physical therapy gives you the ability to use the skill-set you cultivated at the beginning of it all, before insurance began dictating what you could and could not do. This means more time to be hands-on and solve complex problems with patients, and less time spent on an excess of documentation and fruitless negotiations.


Need more convincing? Danny began his cash-based practice with under $3,000. In six months, he went from zero patients to twenty patients per week, charging $175 per visit. Four years later? Danny runs a 2,000 square-foot practice with a satellite office and four full time physical therapists, without ever having to deal with insurance. Will you be next? It’s amazing what can happen when you go back to the basics, that is, the skill-set you cultivated throughout your years of schooling and the passion you have for your patients.