+1 (617) 982-3539
General Information:
Check your insurance card for copayment information:
​
-
If your deductible is not on the card, I would advise contacting the member service's number on the back of the card.
​
Almost every health plan has a copayment and/or a deductible:
​
-
A deductible is the amount that a patient must pay out of their own pocket before their insurance starts to pay.
-
A copayment is a per visit payment that is charged to the patient at each visit.
-
It is common to have a copayment for each visit even after a deductible is paid in full.
​​
Almost every health plan has limits to the number of visits and/or time frames (per year, per month, within 90 days) within which the number of visits must be used.
Please get familiar with any limits your plan has.
Aetna
Authorization sent from your primary care physician's office to Aetna is usually not needed however, the only way to be sure, is for the patient to contact Aetna member services and ask about their benefit for seeing an in network physical therapist.
​
To estimate your costs:
Aetna pays at a rate of approximately $150 per initial evaluation and treatment and approximately $90 per follow-up. For those with a deductible these rates can be expected until that deductible is paid.
For those with a copayment, a patient can expect a specific per visit cost so the total cost can be calculated simply by adding up the number of visits within our plan of care.
BlueCross BlueShield
PPO:
Authorization sent from your primary care physician's office to BlueCross BlueShield is not needed, however other forms of authorization may be necessary for BlueCross BlueShield plans from States OTHER than Massachusetts.
If you are unsure, please contact member services.
HMO:
Authorization must be sent from your primary care physician's office to BlueCross BlueShield to approve PT visits. 1st authorization can be for 26 visits good for 365 days. Extension of that authorization is something that I can file for but is subject to their review.
​
If it is unclear if your insurance is HMO or PPO contact member services.
​
To estimate your costs:
BlueCross BlueShield pays at a rate of approximately $175-$185 per initial evaluation and treatment and approximately $95-$115 per follow-up. For those with a deductible these rates can be expected until that deductible is paid.
For those with a copayment, a patient can expect a specific per visit cost so the total cost can be calculated simply by adding up the number of visits within our plan of care.
Harvard Pilgrim
Authorization sent from your primary care physician's office to Harvard Pilgrim is not needed, however other forms of authorization may be necessary for Harvard Pilgrim plans from States OTHER than Massachusetts.
If you are unsure, please contact member services.
​
PT services are authorized on a 6 month basis. Most of the time I can get 25 visits authorized for a 6months period.
I share each authorization (visits and time limitations) with the patient so that we can work together to avoid exceeding the limits and therefore extra costs.
​
To estimate your costs:
Harvard Pilgrim pays at a rate of approximately $120-$130 per initial evaluation and treatment and approximately $75-$80 per follow-up. For those with a deductible these rates can be expected until that deductible is paid.
For those with a copayment, a patient can expect a specific per visit cost so the total cost can be calculated simply by adding up the number of visits within our plan of care.
​
​