All treatment sessions are 1 hour and are one-on-one with a Doctor of Physical Therapy. The rate for treatment sessions and other services vary, so please call us at (636)686-0503 to inquire about pricing.

We are an out of network provider. This means that you would utilize your out of network benefits instead of your in network benefits. We provide you with superbills (a fancy name for a medical receipt that include the necessary codes) to send self-claims to your insurance company.

*** Please read below on how the changes in many health insurance plans and deductibles have actually made it cheaper to not use your insurance for some services (like PT) if you have high PT copays or a high deductible. 

(Excerpts from our FAQ page)

Why is insurance not billed at St. Louis Women’s Physical Therapy and how can that actually save me money?

The short answer is that insurance companies dictate or strongly influence the treatment that patients receive at “in-network” clinics, and we refuse to allow that to be the case at St. Louis Women’s PT.

The longer answer is that we are an out-of-network provider because the business model necessary for an in-network practice to survive rarely ever allows for the high quality care we insist on giving our patients. Due to progressively worsening reimbursement rates and pressure from insurance companies, the therapists at in-network clinics have to see at least 2 patients per hour (usually many more) and they often use technicians and assistants (PTAs) to provide much of the actual patient care. The care often includes modalities (i.e. biofeedback), and the majority of a patient’s time at the clinic is spent doing exercises they could do on their own time. Furthermore, these types of clinics tend to require patients to attend 2-3 appointments per week.

We do not believe that machines are nearly as effective as hands-on treatment, and we also do not agree with having you pay to perform exercises in the clinic that you can easily perform at home or at a gym. With something as personal as pelvic floor PT, we do not want to be bouncing back and forth between you in a room and other patients somewhere else. We want you to have our undivided attention. And we want to promote independence, not dependence.

All of our patients receive 1-on-1 care and hands-on treatment from a Doctor of Physical Therapy in
every session. With this hour long, 1-on-1 treatment approach, 95% of our patients only attend one appointment per week, and we work to get to once every 2-3 weeks. We also ensure short wait times-no 100+ patient wait list, making you wait 2-4 months to be seen. When you consider the time savings of fewer trips to the clinic and the value of resolving your symptoms so much faster than average, the out-of-pocket expense at St. Louis Women’s PT is a huge bargain.

On top of that, the out-of-pocket expense for our treatment sessions is sometimes
less than a patient would pay at a clinic that accepts and bills their insurance.

How is that possible?

As deductibles and PT copays have skyrocketed in recent years, many of our patients who have high PT copays or have not met their deductible pay less out of pocket for our treatments than they would if they went to a clinic that “takes their insurance.” So before deciding on where to get PT based solely on which clinics “take your insurance,” make sure you know how much you’ll be paying at your in-network options versus an out-of-network clinic like ours.

These days, some insurance plans provide zero coverage for PT visits or require copays of over $50/visit. And if you have a deductible to meet, you’ll likely end up paying the full bill for your PT sessions until you meet the deductible (and these bills are often $200+ per session). However, you usually won’t start receiving those $200+ bills until after you’ve been getting care for 6-8 weeks and have racked up an enormous total balance (again, often being asked to attend PT 2-3 times per week).

Most people are quite unaware of the games their insurance companies play in order to pay out as little as possible and maximize their profits. In 2022, UHC made 30 billion dollars.
Billion with a B.
They have not increased reimbursement for physical therapy in 10-20 years. Sometimes your copay is more than UHC is paying your therapist.

As you weigh your PT options, it’s very important to:

1) Inquire with your insurance company about what percentage of the total PT bill you will be required to pay at an in-network clinic (especially if you have not met your deductible). If you will be paying 100% of the bill until you’ve met your deductible, ask the prospective PT clinic the amount of the average bill sent to an insurance company. In most cases, you will ultimately be paying the full bill until your deductible is met. If you have met your deductible, ask how much your copays will be. Ask how many times per week the average patient is asked to come in for treatment.

2) Consider the quality of care you’ll be receiving at your various options, and how much value you place on receiving high quality, 1-on-1 care from the same Doctor of Physical Therapy rather than a PT Assistant (PTA), unskilled tech, or being bouncing between different therapists each session.

3) Consider how often you’ll be missing work and/or time with family to attend your PT sessions. Again, you can ask any prospective clinic how many times per week their average patient is asked to come in for treatment and how many weeks treatment usually lasts.

Ask the above questions, do the math, and you may be quite surprised at what you find!

*One other thing to consider is whether or not you have just one deductible or if you have both an in-network deductible and an out-of-network deductible. If you have two deductibles, then claims from an out-of-network clinic like ours will not apply to your in-network deductible. With all the above information, you can now get a real sense of what your true costs will be, what level of care you’ll be getting, and then make the best decision on where to receive your physical therapy treatment.

Can I bill my insurance for out of pocket expenses?

This depends on the insurance you have, but YES, most NON-Medicare patients can send “self-claims” to their insurance company for their treatments at our clinic. You should be able to print claim forms off your insurance company’s website, and send it in with the needed receipts and treatment codes that will be provided upon request at our clinic.

The amount of reimbursement or application towards your deductible is completely dependent on your insurance plan. If you call your insurance company to inquire about what you can expect to receive, you should ask if your plan includes out of network benefits.

If the answer is yes, ask:

1. Do I have an out of network deductible?

2: Have I met the deductible for the year? If not, how far away am I from meeting it?

3. Is there paperwork that must be filled out when submitting the out of network claims? If so, do you provide that paperwork?

4. Do I need to be pre-certified for physical therapy sessions in order to receive reimbursement?

Medicare Beneficiaries: The US government has some interesting laws that control where Medicare beneficiaries can spend their healthcare dollar and persuade healthcare providers to enroll in their system. Because we are not
Participating Medicare Providers, we can only accept Medicare beneficiaries as patients when the patient does not
want Medicare billed for any PT services. This request to not involve Medicare in payment must be made up front by the patient and be made of the patient’s own free will. In other words, if you’re a Medicare beneficiary and are adamant about seeing us for your care even though we are not participating Medicare providers, we can help. However, the only way we can provide you with PT services is when you truly don’t want Medicare involved and you ask up front that Medicare not be billed or involved in your physical therapy care. If you do want to use your Medicare benefits for physical therapy, we cannot provide you with treatment at our clinic but we can help you find a good Medicare provider in your area.