Private Pay vs. Insurance PT: What They Don’t Tell You at Checkout

Choosing the right path for physical therapy can feel overwhelming—do you go through insurance, or is private pay a better fit? Both have their perks and challenges, and the best choice depends on what works best for your body, schedule, and budget. Let’s break it down in a way that actually makes sense so you can feel like you can make a confident, educated decision!

Disclaimer: This was written based on personal experiences from multiple UpLift PT providers who have worked in various settings, as well as many real patient stories.

Treatment Approach

Insurance-Based Clinics:

These clinics may place more emphasis on identifying your basic functional impairments that align with what insurance will cover, such as pain and/or incontinence, rather than your higher-level personal goals.

If your main concerns are basic mobility challenges, such as rolling over in bed, standing up, going up and down stairs, or doing household chores, and you’re okay with focusing only on those, they can help. However, if you’re aiming to jump on a trampoline, run a mile, return to HIT-workouts, improve the appearance and feel of your C-section scar, regain feeling in your lower abdominals, enjoy pain-free sex in all positions, or enhance sensation, they may not have the specialized experience, equipment, or time to get you there. Additionally, clinicians in this setting are also under a lot of pressure to get new patients in, and you may find yourself being pushed out towards the end of your plan of care even if you haven’t quite met all your goals, especially once standardized tests stop showing improvement.

Private Pay Clinics:

Private pay clinics take a more customized approach, tailoring treatment plans to fit the patient rather than making the patient conform to a cookie-cutter plan. Therapists have more flexibility to address the root cause of dysfunction, incorporating a wider range of techniques such as dry needling, visceral mobilization, behavioral modification, birth preparation, and partner sessions with your significant other. The goal isn’t just short-term symptom relief—it’s getting you back to the activities you love with a body that feels strong and capable.

UpLift Physical Therapy & Performance:

At UpLift, we take a fitness-forward approach to pelvic floor therapy. You’ll never hear us say, “Just don’t lift heavy” or “You should probably avoid high-impact exercise”—instead, we focus on helping you return to the activities you love, whether that’s weightlifting, CrossFit, running, or simply playing with your kids without discomfort.

One thing we always say is “common, NOT normal!” Leaking during workouts, pain during sex, or pressure with movement might be common, but that doesn’t mean you have to accept them as part of your daily life. Our goal is to empower you with the right tools and strategies so that your body supports you, not limits you.

We’re dedicated to providing an evidence-based, efficient, and goal-oriented plan of care. But life happens! If it takes you a bit longer to reach your goals, or if new ones come up along the way, we’re here for it. And if you want to address something else in your body, we’re on board for that, too! You’ll never feel rushed or pushed out before hitting your milestones. What matters most to us is that you feel successful, not just what a test score says.

And while we are fitness-forward, that doesn’t mean we take a one-size-fits-all approach. We meet you where you are—whether you’re a seasoned athlete or just beginning your journey toward movement without pain. Every treatment plan is built specifically for you, with recommendations that fit your personality and lifestyle, ensuring that you get the care you need to feel confident and strong in your body again.

One-on-One Care

Insurance-Based Clinics:

Insurance-based clinics may or may not offer 1:1 care, so it’s important to ask about their treatment model.

Specialty programs like pelvic health often face challenges within insurance-based clinics. For example, insurance reimburses the same amount for a pelvic health visit as it does for treating knee or shoulder pain. In fact, the reimbursement rates for physical therapy visits are often too low to support seeing just one patient per hour. As a result, these clinics need to see more patients to cover costs. This isn’t about greed—it’s just the reality of how many insurance-based companies operate.

Now, you might not mind sharing your treatment hour when it’s just your knee that needs attention. But when it comes to pelvic health, having another patient around can feel a little uncomfortable, especially when your treatment involves more sensitive areas. Plus, seeing two patients at once often means your care happens in a large, communal space instead of a private room. This can lead to adjustments in your treatment plan—sometimes based on scheduling constraints rather than what’s best for you. Some clinicians are experts at working within these limits, while others might not manage it as smoothly. It really depends on the clinic and the provider.

Many patients experience spending the first 20-30 minutes of a visit with their PT, but being handed off to a tech with a list of exercises to perform for the remainder. You’re having to come 2x a week just to see a PT for a combined 60 minutes. Without 1:1 care, you may require more visits to achieve the same results, especially if you need hands-on care. You might even be advised to come 2-3 times per week to compensate.

Private Pay Clinics:

Private pay clinics often prioritize personalized attention, allowing for dedicated one-on-one care. Here, you can expect to have the full focus of your therapist throughout your entire session. This tailored approach means you’re not just another appointment on a busy schedule; you’re an individual with unique needs and goals. Your therapist guides you through each exercise, ensuring that you understand the process and are performing movements correctly.

UpLift Physical Therapy & Performance:

At UpLift, we take pride in offering the highest level of pelvic health care. You’re never handed off to a tech or left alone in the gym to struggle through exercises. Our team of pelvic floor therapists offers a variety of backgrounds and specialties, including orthopedic care and lymphatic massage. This means that when you work with us, you’re not just getting one brain; you’re tapping into a collective wealth of knowledge and expertise. We often collaborate and co-treat to provide the most comprehensive treatment available, ensuring you receive the best care tailored specifically to you.

Choice of Therapist

Insurance-Based Clinics:

Many insurance-based clinics have one pelvic health provider per region, meaning you likely have one option for your provider. Spacing out of these clinicians also means they likely have less access to hands-on clinical mentorship and sometimes only remote access. It is not uncommon for that clinician to be newer to pelvic health either, since these larger companies are a good way for clinicians to try out new specialties. (As background information, a physical therapist can say that they treat “internal pelvic health” after taking only a singular weekend course). With that said, you could also get lucky and land the head of a women’s health residency program! You just don’t always know who you’re going to get, and because providers are usually spread out, you don’t usually have the option to see anyone else.

Private Pay Clinics:

Private pay clinics allow for much more flexibility in choosing a provider. Usually, there are several providers in one office that can meet your needs. There is also typically higher value placed on keeping you with one or two therapists throughout your plan, allowing for improved continuity of care.

Many private pay clinics also specialize in certain areas, making it easier to find an expert in pelvic health, sports rehab, or other niche fields. Furthermore, clinicians who choose to work in a specialty clinic are never just trying out a specialty; they are usually very passionate about it. This means you get highly specialized care from someone who truly understands your condition and goals.

UpLift Physical Therapy & Performance:

At UpLift, you’re not limited to just one option—you get a team of experts working together to support your care. We have a talented group of six pelvic floor physical therapists, each with different backgrounds and specialties, so you can choose the provider that best fits your needs.

As mentioned earlier, we are a highly collaborative team. Many of our patients receive treatment from multiple therapists to ensure they’re getting the most well-rounded care possible. For example, if a patient is working with one of our therapists for pelvic floor-related concerns but also needs guidance on hip stability and lifting form in CrossFit, they might co-treat with another therapist who has an extensive orthopedic background. This integrated approach ensures that you’re not just getting one perspective—you’re getting the collective expertise of our entire team.

At UpLift, you’re never stuck with a provider who isn’t the right fit. Our goal is to give you the best care possible, whether that means working with one therapist or collaborating as a team to support your full-body health.

Appointment Availability

Insurance-Based Clinics:

One of the biggest frustrations with insurance-based clinics is limited appointment availability. Many of these clinics operate on a high-volume model, meaning appointments fill up fast, and securing a time that fits your schedule—especially if you need early morning or evening slots—can be difficult. Weekend times are rarely an option.

Additionally, since insurance-based clinics often have fewer pelvic floor specialists, there may be long wait times just to get started. If you’re looking for a specific provider, you could end up on a months-long waitlist before you’re even evaluated. And once you do start treatment, follow up visits may be equally as limited. You may need to work with another non-pelvic provider in the office during times when your pelvic health specialist has a full schedule, or you may need to wait until they have an opening.

Private Pay Clinics:

Private pay clinics generally offer more flexibility with scheduling since there are often more providers who can meet your needs, and all of their patient slots are dedicated to the pelvic health specialty.

Wait times to start treatment are usually much shorter than in insurance-based clinics, and because these clinics tend to have smaller caseloads, they can often accommodate your schedule rather than the other way around. Since sessions tend to be longer and more in-depth, most patients need fewer visits. Fewer visits also mean less time spent traveling to and from appointments, making it easier to fit PT into a busy life.

UpLift Physical Therapy & Performance:

At UpLift, we understand that your time is valuable, and getting the care you need shouldn’t come at the cost of rearranging your entire schedule. With a team of six highly trained pelvic floor therapists, we offer a wide range of appointment times, including early morning and late evening, on top of our standard 9-5 hours. Whether you need to come in before work, after dropping the kids off, or later in the evening, we’ve got you covered.

Another advantage of having a team of specialists is that your care never has to hit pause. If your therapist is ever sick or on vacation, another provider can seamlessly step in—fully caught up on your plan of care—so you can stay on track with your treatment and continue making progress without unnecessary delays.

Unlike many clinics, you will rarely—if ever—be placed on a waitlist. We intentionally reserve spots for new patients, ensuring that you can start care quickly and easily rather than waiting weeks or months for an opening. At UpLift, we make it a priority to keep our services accessible and convenient, so when you’re ready to prioritize your health, we’re ready for you.

Cost Considerations

Insurance-Based Clinics:

At first glance, insurance-based clinics may seem like the most cost-effective option, especially if you assume you’ll only be responsible for a co-pay. However, if you haven’t met your deductible, you could end up paying significantly more out of pocket than expected—sometimes similar to or more than what you would pay at a private clinic.

We get it—understanding insurance is confusing. It’s meant to be that way. Many people assume that their insurance will cover most of their treatment, only to receive a surprise bill weeks or months later when certain services aren’t covered or are billed at a higher rate than expected. (Background: visits are billed based on what type of treatment the therapist completes, so the pricing of visits will likely vary, between about thirty and seventy dollars each time). This uncertainty can make it difficult to budget for your care.

Private Pay Clinics:

With private pay clinics, the cost is transparent from the beginning. You know exactly what you’re paying for without hidden fees or surprise charges. While it is a larger upfront investment, you’re paying for highly personalized, one-on-one care designed to get you better in fewer visits. Many private pay clinics also provide superbills, allowing patients to submit claims for potential reimbursement from their insurance providers.

UpLift Physical Therapy & Performance:

While we are a private pay clinic, we are also an out-of-network provider—which means that, while we don’t bill insurance directly, most of our clients still use their insurance benefits. We provide detailed superbills, and many of our patients successfully file for reimbursement with their insurance provider. In fact, we’ve found that some insurance companies reimburse patients better than they reimburse in-network clinics.

We also believe in full transparency when it comes to cost. The price you pay at UpLift is the only cost you’ll ever have. There are no hidden fees, no unexpected charges, and no surprises. What you pay is what you pay—simple as that!

Unlike some clinics where you might assume you’re only responsible for a co-pay but later get hit with a large bill, we remove that uncertainty. At UpLift, we eliminate that stress so you can focus on healing instead of worrying about financial surprises.

Number of Sessions

Insurance-Based Clinics:

Some insurance plans limit the number of sessions they will cover, regardless of your condition or progress. Yes, you read that correctly: the insurance company dictates what you “need” instead of your Doctor of Physical Therapy. This means your treatment plan may be cut short, even if you still need support to fully recover.

Some insurance providers only cover what they consider “medically necessary.” Unfortunately, things like pain with sex, urine leakage while running, diastasis recti, or the appearance of a C-section scar don’t always meet the criteria for physical therapy coverage. If these are your main concerns, it’s worth checking with your insurance to see if they’re covered. State-funded plans like Medicare and Medicaid tend to be strict about this, while coverage can vary with private insurance.

Furthermore, if the insurance-based clinic is not able to provide you with 60 minutes of 1:1 care, it’s possible that you will need more visits in order to get the same results, which means more time, preparation, commute, and money from you.

Private Pay Clinics:

In a private pay model, your treatment plan isn’t dictated by an insurance adjuster—it’s based on your needs, your goals, and your progress. There are no predetermined session limits, and your therapist doesn’t have to jump through hoops just to get you the care you deserve.

You and your provider can make adjustments as needed—whether that means increasing or decreasing your frequency based on your progress, adding additional sessions for maintenance, or continuing treatment for wellness and injury prevention rather than just symptom resolution.

UpLift Physical Therapy & Performance:

At UpLift, we don’t believe in limits on your care! There’s no outside party deciding how many sessions you “get” or how fast you should recover—we work as a team with our patients to create a personalized treatment plan that makes the most sense for you.

Your session frequency is based on your needs and goals, and it’s always re-evaluated as you progress. Some patients come in weekly, while others may transition to biweekly or monthly check-ins as they get stronger. And if you want to continue beyond rehab for wellness and injury prevention, we fully support that, too!

At UpLift, you’re in control of your care—whether that means working with your therapist to fine-tune your plan of care or continuing treatment to stay strong, active, and pain-free. No session caps, no outside limitations—just the care you need, for as long as you need it.

Paperwork & Authorizations

Insurance-Based Clinics:

Some insurance plans require prior authorization before you can start therapy, and even after you begin, your care can be paused while waiting on approvals for additional sessions. Unfortunately, your timeline for treatment is often at the mercy of both the therapy clinic and your insurance provider, and getting them to cooperate isn’t always easy. It can take multiple phone calls, time spent on hold, back-and-forth communication, and frustrating delays before you’re able to move forward with care.

Private Pay Clinics:

With private pay, there’s far less red tape. Since your care isn’t dictated by insurance requirements, you don’t need prior authorizations or approvals before getting the treatment you need. You simply schedule an appointment and start care without waiting for an outside party to sign off on it. We do recommend checking with your physical therapy clinic about referral requirements, as some states still require a referral for private pay PT while others do not.

UpLift Physical Therapy & Performance:

At UpLift, we believe starting and continuing care should be as seamless as possible. That’s why we keep paperwork to an absolute minimum—just a short and sweet intake form that you fill out once. That’s it. No insurance authorizations, no waiting periods, and no interruptions to your plan of care (POC) because of paperwork delays.

The only requirement we have in Texas is that we must receive a referral within 10 business days of your initial evaluation. But don’t worry—this referral can come from a variety of healthcare providers, including your PCP, chiropractor, midwife, OB/GYN, or another qualified professional. The good news? You don’t need the referral to start treatment! You can begin care right away while you work on obtaining it, so there’s no unnecessary waiting.

At UpLift, your progress is determined by you and your therapist—not paperwork, policies, or insurance red tape.

So, Which Option is Best for You?

Generalizations made in this article may or may not reflect the reality of every insurance-based setting or every private pay setting. However, we hope that it helps you know what questions to ask when looking for a clinic.

Ultimately, the choice between insurance-based and private pay physical therapy comes down to what you value most in your care. If having predictable costs, fewer administrative barriers, and a truly individualized approach is important to you, private pay may be the best fit. On the other hand, if using in-network benefits and keeping upfront costs lower is your top priority, an insurance-based clinic might align better with your needs.

At UpLift, we’ve built a model that prioritizes your goals, your schedule, and your success. We believe that access to high-quality pelvic health care shouldn’t come with unexpected bills, frustrating delays, or unnecessary restrictions. Whether you need a structured plan to rehab an injury, support to stay active in the gym, or guidance on feeling stronger in everyday life, we’re here to help—on your terms.

When it comes to your health, you deserve options, and at UpLift, we’re proud to provide a care experience that is clear, empowering, and designed just for you.

Note: This was written based on personal experiences from multiple UpLift PT providers who have worked in a variety of different settings, as well as many real patient stories.

Contact Us

More questions on insurance vs. private pay physical therapy? Reach out—UpLift is here to guide you through your pelvic floor journey!

UpLift Physical Therapy Website

Phone: 210-468-7398

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