Frequently Asked Questions and Good Faith Estimate
Why choose Joe Norton Physical Therapy?
We are the best in DC. Simple as that.
You will not find another clinic that provides this level of expert care, 1 on 1, with one hour sessions and your goals at the epicenter. Our goal is to give you the confidence to reach your own goals, with us there to facilitate in any way we can.
What conditions do you treat?
We are specialty trained in orthopedic physical therapy with certifications in functional manual therapy and orthopedic manual therapy. In addition to our hands-on skills, we are also certified in dry needling and many different exercise approaches like Crossfit, kettlebells and FMS.
We are capable of treating head to toe, literally. Our previous work experiences have provided us with the opportunity to work with a variety of populations- runners, crossfitters, tennis players, active adults. All of these clients have dealt with injuries affecting their sport, lifestyle or mobility.
What happens at an initial appointment/evaluation?
Our goal of an initial appointment is to examine any areas causing pain and decreased mobility. Through taking a thorough history and performing a clinical examination, we will identify a diagnosis.
Additionally, we will assess how your body moves through observing and testing functional movements such as running, walking, squatting, deadlifting etc. This assists our ability to identify underlying issues such as, restrictions in motion, strength deficits or motor control limitations.
Finally, the session will conclude with a discussion of a treatment plan and may include demonstration of a home self care program, education on what’s causing your issue and manual therapy.
If you have more than one area of pain affecting your mobility, for example knee and shoulder pain, then we may need more than an hour to appropriately assess each concern. In this event, we will try to cover as much ground as possible and pick up where we left off during a follow up session.
Who will I work with?
We will match you with one of our therapists based on your injury, your goals, and our availability. You will work one-on-one with a Physical Therapist for the entirety of your appointment. We never double book appointment times, or pass you off to a PTA.
What should I wear? What should I bring?
Dress comfortably – shorts, t-shirt or sports bra, and your preferred running or training shoes. You don't need to bring anything else with you, but please complete our intake forms online before your first appointment as this will give your therapist valuable information about you as well as decrease time spent reviewing your history during your appointment.
Where are you located?
We are at 3222 N St NW, suite 400 in Washington, DC.
Parking on the neighborhood streets may be metered or limited to 2 hours. Generally if you permit an extra 5 to 10 minutes, you will find a parking spot within 1 to 4 blocks of the practice.
If you prefer there is a parking garage located at 3251 Prospect St NW.
Do I need a referral before I can be seen?
Washington, DC has direct access laws meaning you can schedule an appointment with a PT without physician referral. We can schedule an evaluation appointment as soon as you're ready. However, our therapists are happy to collaborate with any other healthcare professionals you are working with to ensure the best care possible for you.
Do you take insurance?
In order to offer the highest value of care, we are an out-of-network provider with all health insurances. This allows us to provide hour long 1 to 1 treatments, where we can focus on giving you our full time, attention and expertise.
What is an out-of-network provider?
This just means the therapists here have not entered into a contract with individual insurance companies to receive reimbursement through their contracted rates. There are SO many insurance companies with varied rates and policies and regulations- our energy is best spent on providing high level care.
In our treatment model, the physical therapist enters into a contract with the client directly. The client pays at the time of service allowing the therapist to focus all their attention on providing the best service and minimizing time spent on insurance reimbursement.
This also allows you, as the patient, to know exactly what the treatment will cost you without any blind bills. While going through insurance, the amount billed will vary based on the codes billed each session. This often results in confusing bills for the patient based on these varied rates. Private pay PT eliminates all confusion and allows for clarity in decision making for the client.
Will I end up paying more for PT?
Research says NO! Cash based PT has demonstrated it requires less sessions to meet your goals, get you out of pain and get you moving better so overall the total cost ends up reduced to insurance based clinics! Twice a week for 8 weeks is not the right prescription for everyone!
Check out the cost comparison.
What's the difference between In and Out of Network PT?
At an insurance based clinic, a physical therapy session may include a few minutes with the PT, some exercises with support staff and some passive modalities. While passive modalities might feel good, they will not fix you.
At Joe Norton PT, your session will be spent actually addressing your root problem and helping to fix it through exercise, education and manual techniques.
We do not use passive modalities or aides in your care because your time is valuable and should be spent making lasting change toward fixing your problems, not just temporary fixes.
Can my insurance be billed for cash based PT?
Joe Norton Physical Therapy does not accept or bill through insurance. However most insurances with the exception of medicare, Medicaid and some HMO’s, will provide some payment for services received “out-of-network”.
Therefore you can submit your sessions at Joe Norton PT to your insurance company and they will reimburse you directly at their out of network physical therapy rates. You will receive a check in the mail. The end goal of documentation and billing is the same however, to get paid in this system, it is the patient waiting for reimbursement instead of the provider.
What steps are involved in submitting a claim?
We will gladly provide you with a receipt/invoice/superbill after each session, for you to pursue reimbursement from your health insurance carrier for our services. Depending on your insurance policy you may receive reimbursements. Most insurances cover some if not all of your PT services, with the exception of medicare, medicaid and HMO. Of note, We DO NOT have a relationship with Medicare.
At no extra cost, we do a courtesy claim submission. All you need to do is let us know you would like to utilize this service, give us your name, date of birth, and a photo of the front and back of your insurance card. We’ll take it from there! You will still need to pay for your care at the time of visit. We then submit the invoice to the insurance company and they will pay you, not us. This process can take 6 to 8 weeks.
How do I know if my insurance covers out of network physical therapy?
You can easily determine your out of network Physical Therapy benefits by calling the phone number on the back of your insurance card. Ask the following questions:
What is your coverage for out-of-network physical therapy and what does it include?
Is pre-authorization is needed for physical therapy services.?
What information is required in order to be reimbursed (i.e. is there a special form that needs to be completed)?
Is a physical therapy prescription needed from your physician?
Are physical therapy office notes required?
Find out if there are any limits for coverage in terms of dollars per year, visits per year, or visits per condition.
Good Faith Estimate
Under the No Surprises Act, as of January 1st, 2022, all patients receiving healthcare are entitled to a Good Faith Estimate, outlining the expected cost of care. This Good Faith Estimate is intended to outline the cost you may incur while receiving care at Joe Norton Physical Therapy. We are happy to provide estimates upon request.
In working with Joe Norton Physical Therapy, your Physical Therapist will work with
you to recommend a package of sessions in line with a Plan of Care that in their expert opinion will allow for the most economical and efficient solution to your injury and/or pain. Our goal is to be as transparent as possible regarding your care as well as the cost associated.
Here is our pricing structure:
Physical Therapy Evaluation: $249.00
Physical Therapy Follow-up Appointments (60 minutes):
Single Session: $249.00/session
Package of 6 sessions: $229.00/session, $1374.00 Total
Package of 10 sessions: $199.00/session, $1999.00 Total
Package of 20 sessions: $189.00/session, $3780.00 Total
Potential Billing Codes Utilized:
97163 - Initial Evaluation
97140 - Manual Therapy
97530 - Therapeutic Activity
97112 - Neuro Re-education
97110 - Therapeutic Exercise
*The above codes may be changed based on package pricing discounts
As an out-of-network provider, all pricing is discussed at our onboarding phone call and email as well as at the initial evaluation, and will be for the exact amount owed. The total cost of your care will be paid upfront, or a payment plan may be arranged with Joe NortonPhysical Therapy. The plan of care after the evaluation may include manual therapy, exercise prescription, home exercises, and fitness training, and will be updated in accordance with your progress.
Within the course of the plan of care, things may change, and your therapist may recommend
more or less sessions, and at this point we discuss the cost associated.1
If the actual cost of services provided exceeds your Good Faith Estimate by $400 or more, you have the right to dispute the bill via the U.S. Department of Health and Human Services. It may be easier to contact Joe Norton Physical Therapy directly to resolve any disputes.
If you choose to use the dispute resolution process, you must start the dispute process within
120 days of the date of the original bill. The dispute process will cost $25. If the agency
reviewing the dispute agrees with you, you will have to pay the amount outlined in the Good
Faith Estimate. If the agency disagrees with you, and agrees with the health provider, you will
have to pay the higher amount.
If you have any questions, or want more information regarding this, you can visit
www.cms.gov/nosurprises or call the No Surprises help desk at 1-800-985-3059.
How long will it take?
Physical Therapy evaluations range in time from 60 to 75 minutes depending on the nature and complexity of your case.
All follow up appointments take 60 minutes, but can be flexible to change per your availability.
Most of our patients are seen once or twice a week. The duration of your treatment is impacted by many factors, but more common issues are typically resolved in about 6 to 8 weeks.
Why would I choose to pay out of pocket when I can use my insurance at another clinic?
Cash based physical therapy has actually shown to cost the patient less versus going through insurance. We provide only one-on-one treatment sessions for 60-minutes each visit. These one-on-one treatments may include dry needling, cupping, joint mobilizations and other manual techniques with the entirety of the session involving a hands on approach.
Many other clinics have their physical therapists seeing 4-5 patients per hour, vastly limiting any hands-on time. The sessions may be spent with a rehab aide training you on how to perform the same cookie-cutter exercises with no individualization and minimal results. They will try and book you 2-3 times per week for 8-10 weeks and still have lower patient satisfaction rates and worse outcomes toward pain relief and functional activity tolerance.
Joe Norton PT will require less overall sessions to meet your goals than traditional insurance PT because of the increased time spent on your care. Come experience what physical therapy is really like with individualized, genuine, one-on-one care of a Doctor of Physical Therapy.