Rates & Insurance
Rates (as of 9/01/24)
- For ages 8 and up to adults, the initial eval is 60 minutes = $140
- Ages 8 and up to adults follow ups are 45 minutes = $105
- Newborn to 7 years, the initial eval is 45 minutes = $105
- Newborn to 7 years, follow ups are 30 minutes = $70
- Children 8-12 (time treated may vary 30-45 minutes)
- Telehealth Consult ($35 per 15 minutes)
- Group Exercise or Unwinding: MFR Yoga/Qigong classes $30 (package of 4 for $80) can be purchased.
- Private Exercise / Unwinding:
- Schedule an individual unwinding exercise session for $70 for 30 minutes
Clinic Treatment Codes / Units
- Manual Therapy (97140): $35 per 15 minute unit
- Neuro Re-education (97112): $35 per 15 minute unit
- Therapeutic Exercise (97110): $35 per 15 minute unit
- Telehealth consults. $35 per 15 minutes.
Insurance
New Beginnings Myofascial Therapy does not bill directly or contract with insurance companies. Depending on your current health insurance provider or employee benefit plan, it is possible for services to be covered in part for “out of network” physical therapy benefits. You may turn in the claims yourself.
Please contact your provider to verify how your plan compensates you for out-of-network physical therapy services.
I’d recommend asking these questions to your insurance provider to help determine your benefits:
- Do I have a separate out-of-network deductible? If so, what is it and have I met it yet?
- Does my plan limit how many sessions per calendar year I can have? If so, what is the limit?
- Do I need written approval or referral orders from my primary care physician in order for services to be covered?
- Does my plan cover "Craniosacral Therapy"? Some insurance policies have declined to cover CST as "investigational", you should be aware that CST will be included in most if not all sessions.
Why I don’t do direct insurance contract / billing
My program is geared toward spending the whole session hands on and one on one. Many clinics that do insurance billing have 2-3 or more clients at one time with each therapist working out on different pieces of equipment, or they are using support staff for portions of the treatment time. Many clients have told me that when they went to insurance billing PT clinics, they did not get more than 10-15 minutes hands on time with their physical therapist, and had less than ideal results. This is how these clinics are able to bill insurance, take only what insurance pays, and cover the costs involved with billing and collections. I believe that clients deserve and do best with a 1-1 hands on experience. I have noticed that they require fewer visits, make improvements faster, and understand their home program routines better. I focus on teaching you what to do in order to empower you in your own healing. I work with you in a full body way to bring your whole body back into balance (sometimes billing insurance means PT treatment is limited to only the direct area of pain that is on the Dr. order). This is why I have made the commitment to work one on one with my clients and give the best care possible.
MFR Unwinding / private sessions or MFR Yoga/Qi Gong group classes are not covered or reimbursable for most major insurance carriers.
Good Faith Estimate
Your physical therapy treatment will include an initial evaluation and a combination of treatments that may include manual therapy (myofascial release, cranial sacral therapy), exercise, and yoga / or physical training, or myofunctional exercise techniques. If you have any questions about your upcoming appointment, please don't hesitate to reach out before your visit.
The total cost of your care will include the initial visit, plus any follow-up visits, and will be paid as you go. This business does not directly bill insurance and some services may be considered wellness and not reimbursable under self-claims.
PAYMENTS: New Beginnings Myofascial Therapy LLC provides holistic therapy approaches that include the full body, mind, and spirit to help you overcome the sustained stress and tension in your body which may include: Myofascial Release, Craniosacral Therapy, Qi Gong, MFR Yoga, Orofacial Myofunctional Therapy Exercises. These methods may be considered “investigational” or “non covered” for some insurances. Payment is expected at the time of service in the form of cash, check, HSA, debit or credit cards (via stripe).
NBMT does not do any direct billing and is not in network with any insurances. New Beginnings Myofascial Therapy LLC is not contracted or enrolled with Medicare, Medicaid (TnCare) or any other commercial insurance plans. If you have Medicare, Medicare Advantage plans, Medicaid (TNCare) you cannot do self claims for unenrolled providers.
You will be responsible for contacting your insurance company to pre- authorize and determine your coverage and self claim procedures. If you are self-claiming insurance and need coded Superbills, please let me know and I will provide those. NBMT will be happy to provide you with a list of physical therapists that are able to bill for you.
This Good Faith Estimate shows the costs of items and services that are reasonably expected based on your health care needs. The estimate is based on information known at the time the estimate was created. It does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
This Good Faith Estimate is not a contract and does not require you to obtain the services or items from the providers or facility identified in it. You have the right to request another Good Faith Estimate at any time during your course of care.
Additional items and/or services that are not in the good faith estimate may be recommended by the convening provider as part of the course of care, that must be scheduled separately and are not reflected in the good faith estimate (such as rehabilitation therapies or other post treatment items or services) and information regarding how you can obtain a good faith estimate for such items or services is available by request.
The good faith estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute the bill. If you are billed for more than this good faith estimate, you have the right to dispute the bill.
You may contact the health care provider or facility listed to let them know the billed charges are higher than the good faith estimate. You can ask them to update the bill to match the good faith estimate, ask to negotiate the bill, or ask if there is financial assistance available.
You may also start a dispute resolution process with the US department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days of the date on the original bill. The patient-provider dispute resolution process may be started if the actual billed charges are $400 more than the expected charges included in the good faith estimate. Please contact the health care provider before disputing the bill to resolve any conflicts directly with the provider first.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the No Surprises Help Desk at 1-800-985-3059.
No Surprises Act / Pricing
As part of the “No Surprises Act”, I want to inform you of your right to request an estimate in advance. As a new client, you will have an evaluation which includes paperwork time, evaluation of your history, postural assessment, hands on bodywork, teaching in home program. Follow up sessions are usually recommended, most clients benefit from around 4 weekly then 4 more biweekly sessions to achieve the results they desire.
The program may also offer wellness based class or semi-private or private yoga, Qi gong, movement classes / personal training or coaching sessions that are priced individually and paid in cash at the time of registration, attendance at these classes is your choice and not part of the good faith estimate.
Payment
I accept cash, credit card, & check as forms of payment. Some health insurance spending accounts have debit cards I can take, contact your health insurance provider for details on how to use your health spending account for physical therapy and wellness services.
Cancellation Policy
Cancellation policy 24 hours, full scheduled session rate will be charged for any no-show or missed visit with less than 24-hour notice.
Late Cancellation and No-Show Fee per policy (within 24 hours of scheduled appointment): full price of the scheduled service, 48 HOURS NOTICE REQUESTED.
Any Other Questions
Please contact me for any additional questions you may have. I look forward to hearing from you!