REFERRALS & BILLING
DIRECT ACCESS & REFERRALS
In Texas, patients now have direct access to physical therapy for up to 30 days without a physician’s referral, which greatly improves their ability to receive timely care. This means individuals can be evaluated and begin treatment with a licensed physical therapist as soon as an injury or issue arises—often significantly reducing the delay between the onset of pain and the start of rehab. Early intervention can prevent minor problems from becoming more serious, improve outcomes, and help patients return to their activities faster.
While this expanded access allows for more efficient and patient-centered care, physical therapists continue to maintain strong collaborative relationships with physicians, surgeons, and other healthcare providers. Referrals are still required after 30 days, and certain post-surgical or complex cases necessitate coordination from the start. By working closely with a network of trusted providers, physical therapists ensure patients receive comprehensive care that’s safe, effective, and well-coordinated across disciplines.
BILLING
At True Grit Physical Therapy, we operate primarily as an out-of-network, cash-based physical therapy practice, with the exception of Medicare. This model allows us to provide individualized, high-quality care without the restrictions and limitations often imposed by insurance networks. Payment is due at the time services are rendered.
For patients with private insurance, we are happy to provide all the necessary documentation—including a detailed receipt (superbill)—to help you file for potential out-of-network reimbursement with your insurance company. Reimbursement will vary depending on your specific insurance plan and your out-of-network physical therapy benefits.
If you have any questions about billing, rates, or how to file for insurance reimbursement, we are here to help. You can contact us at 325-480-3488, and we’ll walk you through the process.
WHY CHOOSE A CASH-BASED PT?
A cash-based physical therapy model offers patients a level of flexibility, personalization, and efficiency that is often difficult to achieve when care is dictated by insurance networks. Under traditional insurance models, treatment is typically bound by visit limits, rigid authorization requirements, and the need to fit within standardized billing codes. These limitations often lead to shorter appointment times, less one-on-one care, and a focus on meeting insurance criteria rather than truly optimizing the patient’s recovery. By contrast, a cash-based model allows the therapist and patient to collaborate directly—without interference from third-party payers—ensuring that every treatment decision is guided by clinical expertise and the patient’s individual goals.
One of the primary benefits of a cash-based approach is more focused, individualized care. Because therapists are not constrained by the billing structures of insurance, they can spend the entire session working one-on-one with the patient. This allows for more thorough evaluations, advanced manual therapy techniques, detailed exercise instruction, and time for patient education. The result is often faster progress, fewer total visits, and more effective long-term outcomes. Many patients discover that even though they’re paying out of pocket, they end up spending less overall because their goals are reached more efficiently than in a system where they may only get 15–20 minutes of direct care per visit.
A cash-based model also gives patients greater control over their healthcare. Rather than waiting for referrals, approvals, or navigating confusing insurance networks, patients can access care when they need it most—within 24-48 hours, not weeks. This immediate access can be critical for recovery, especially in acute injuries, post-surgical rehabilitation, or performance optimization for athletes. It empowers patients to choose their provider based on expertise and quality of care, not just on who happens to be “in-network.”
Additionally, this model supports a higher standard of care because the therapist’s focus remains on clinical excellence rather than documentation for insurance approval. Therapists can tailor treatment frequency and techniques to what’s clinically appropriate, not just what an insurance company deems “medically necessary.” For example, a patient may benefit from advanced manual therapy, sport-specific rehab, or neuromuscular training that isn’t always covered or adequately reimbursed under standard insurance plans. In a cash-based model, these decisions can be made freely, allowing for a more holistic and performance-driven approach to rehabilitation.
Finally, cash-based clinics often maintain transparent and predictable pricing, avoiding surprise bills or complicated deductibles. Patients know the cost upfront and can often use their out-of-network benefits for partial reimbursement by submitting a superbill to their insurance. This transparency, combined with the individualized nature of care, creates a more efficient, patient-centered experience. Ultimately, while insurance-based models may seem more cost-effective at first glance, cash-based physical therapy frequently leads to better results in fewer visits, more autonomy for the patient, and a stronger therapeutic relationship—all of which contribute to superior outcomes.
