Push Not Taking Insurance for Physical Therapy

In 1988, I was halfway through my 6 years of undergraduate college, and somewhat directionless, working on an exercise and sports science degree at Colorado State University. There was no particular post-college life in sight. One day, in the spring of 1988, there was a career fair on campus. I stopped by the University of Colorado Health Science table – now UC Health – and grabbed a pamphlet on its physical therapy program. It seemed as though I might have found my final destination. It was a perfect fit for me, incorporating both science and physical fitness. I was 22 and now maybe I had some direction.

In 1988, there was no internet, so you had to do some digging. A phone call, a campus visit and some extra planning made this happen. By the spring of 1992, I was accepted at CU, and began my post-graduate work on a master’s in physical therapy. At the time, the profession was considered one of the up-and-coming ancillary healthcare professions. Upon graduation, all looked great. I had several job offers and, within several weeks of graduation in late May of 1994, I was starting at my new job working for a workers comp center – Concentra.

I spent the next 6 years there, learning the ins and outs of physical therapy. The insurance industry by 2000 had started to push back a bit, cutting patient visits and asking for extra documentation. This made it tougher to get paid for your work. Late in the summer of the year 2000, I decided to try to open my own small practice, working out of a small personal training gym in the Belcaro area of Denver. I had to apply for all of the private insurance contracts, so I could bill and get paid for my services. At the time – in late 2000 and early 2001 – I was able to get paid per diem by most insurance companies. United Health Care and Anthem-BC/BS paid $65 per session while Cigna paid $51. Humana and Aetna were less and more difficult to deal with. Workers’ comp insurance paid well, as did Medicare. However, those patients weren’t as easy to come by. In 2007, United and Blue Cross increased their pay to $70/session, while Cigna increased to $53.50. These are the big three insurers, so this is where the bulk of business comes from. Fast forward to 2023, and those insurance pay rates have not changed. Not only have the payments been capped at rates from 15 years ago but there is also more paperwork for pre- and post-treatments to get paid for my services. This issue has made it not financially viable to continue in this manner. I cannot think of any other profession that hasn’t gotten a pay increase in the last 15 years.
I have truly loved my career since graduating in 1994. I feel that I have become quite a “healer,” helping hundreds of people recover from injuries over the years and, more recently, helping people learn how to prevent injuries through exercise and fitness. The human body isn’t like the textbooks we studied in school – there are so many working pieces, and it takes so long to learn how to put them together like a puzzle. I feel that the industry loses people like me regularly as we can continue to work for wages that are so out of touch with the rest of society and regular inflation. Over the next several months I will begin to phase out all insurance billing business, however I will continue to see clients on a cash-pay basis, which is sad for so many others who cannot afford my specialized services. I feel that I will be letting so many people down for a few extra bucks. This makes me feel a bit greedy at times. However, not getting a pay raise for over 15 years is quite defeating and, ultimately, unsustainable.  I will also be spending time doing specialized personal training, please contact me directly with any interest in this area.   

Martin Lavine MS, PT

Owner/Physical Therapist/Head Trainer PUSH Fitness and Physical Therapy

303-903-8174  marty@pushgym.com