Physical therapists who run cash-based practices, mobile or in-home PT, or small clinics send invoices for evaluations, treatment sessions, and packages of visits. Many also bill patients directly for the portion insurance does not cover, or provide itemized statements (superbills) that patients submit to their insurer for out-of-network reimbursement.
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Invoice_1001_Client_2026-10-14.pdf
Cash-based and out-of-network PTs usually charge a flat fee per visit, with a higher fee for the initial evaluation and a lower or equal fee for follow-up sessions. Session length drives price, commonly 30, 45, or 60 minutes. Many practices sell prepaid packages of 4, 6, or 10 visits at a small discount. Mobile and home-visit PTs add a travel fee or charge a higher visit rate. Specialty services such as pelvic floor therapy, dry needling, vestibular rehab, or sports performance testing are priced separately. Add-ons like braces, resistance bands, taping supplies, and written reports or letters for employers and attorneys are billed as separate lines. Practices that bill insurance invoice patients for copays, deductibles, coinsurance, and non-covered services, and the amounts depend on the payer contract.
| Service | Priced | Typical range |
|---|---|---|
| Initial evaluation (60 min) | per visit | $125-250 |
| Follow-up treatment session (45-60 min) | per visit | $95-200 |
| Short follow-up or re-check (30 min) | per visit | $65-120 |
| In-home or mobile PT visit | per visit | $150-275 |
| Dry needling add-on | per session | $30-75 |
| Pelvic floor or vestibular evaluation | per visit | $150-275 |
| Prepaid treatment package (6 visits) | per package | $500-1,000 |
| Written report, letter, or records summary | flat fee | $50-200 |
Typical US ranges. Rates vary by region, experience, and job size.
| Description | Qty | Rate | Amount |
|---|---|---|---|
| Initial evaluation and treatment plan, right shoulder rotator cuff strain (60 min) | 1 visit | $175.00 | $175.00 |
| Follow-up treatment session: manual therapy and therapeutic exercise (45 min) | 3 visit | $125.00 | $375.00 |
| Dry needling add-on | 2 session | $50.00 | $100.00 |
| Resistance band set and home exercise handout | 1 each | $18.00 | $18.00 |
| Kinesiology taping supplies | 1 each | $10.00 | $10.00 |
| Total | $678.00 | ||
Notes: Dates of service: March 4, 11, 18, and 25. Payment due within 14 days of invoice date. A detailed superbill for out-of-network reimbursement is available on request. Cancellations with less than 24 hours notice are billed at 50% of the visit fee.
Identifies the correct patient and ties the invoice to the right record, which insurers also require on superbills.
Insurers and patients need exact dates of service, and it prevents disputes about how many visits occurred.
Out-of-network claims are usually rejected without procedure and diagnosis codes, such as 97110 for therapeutic exercise or 97140 for manual therapy.
Insurers generally require rendering provider identification on reimbursement claims.
Required on superbills and needed for the patient's records and HSA or FSA reimbursement.
Itemizing makes it clear what is a treatment service and what is a product, which matters for reimbursement and sales tax where it applies.
Shows what is still owed and avoids double billing when patients pay part at the visit.
Cash-based PTs commonly collect payment at the time of service by card, HSA or FSA card, or bank transfer. When invoicing after the fact, due on receipt or net 14 is typical, and net 30 is more common for attorney, employer, or contracted facility billing. Prepaid packages are paid in full upfront and usually carry an expiration date, such as 90 or 180 days. Many clinics keep a card on file and charge a late-cancel or no-show fee, often 50% to 100% of the visit fee, as stated in a signed policy. Late fees on unpaid balances, if used, are typically 1% to 1.5% per month, and you should confirm what your state allows and that the patient agreed to it in writing.
Have patients sign a policy covering late cancellations and no-shows before the first visit. It is much easier to charge the fee when it is already agreed to.
Patients with out-of-network benefits often ask for one. Giving it automatically saves back-and-forth and makes your cash rate easier to accept.
If you are out-of-network, tell patients that reimbursement is between them and their insurer and is not guaranteed. This heads off disputes over unpaid balances.
State how many visits are included, the expiration date, and what happens to unused visits. Unclear package terms are a common source of refund requests.
Invoices contain health information. Send them through a secure channel and keep records for the period required by your state and any payer contracts.
A superbill is an itemized statement showing the dates of service, CPT codes, diagnosis codes, fees charged, amounts paid, and your provider details. Patients submit it to their insurer for out-of-network reimbursement. Provide one whenever a patient asks, or by default for cash-pay patients with out-of-network benefits.
In most cases yes, if the patient agreed to the policy in writing beforehand. Insurers generally do not reimburse these fees, so they are billed directly to the patient. Check your state rules and any payer contracts, which may restrict charging insured patients.
Treatment services are generally not subject to sales tax, but products you sell such as braces, bands, or supplements may be taxable depending on your state. Check with your state revenue department or a tax professional.
Yes. The evaluation takes more time for history, testing, and documenting the plan of care, so it is usually priced higher and listed as its own line on the invoice.
Usually yes, since physical therapy is generally an eligible medical expense. Provide an itemized receipt or superbill, as some plan administrators ask for documentation of the service and provider.
Send a Physical Therapist estimate for approval, then turn it into an invoice when the work is done.
Physical Therapist estimate template