Going rate for Home Health PT

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Daniel M. Pitta

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I am looking to get into private pay home health PT as a source of supplemental income during evenings and weekends. My question is, is this something that you typically have to go through a HH agency for? Because as I understand, that is typically for patients going through their insurance (typically Medicare, Medicaid, managed care, etc.)

If I'm going with cash patients, am I able to do that without going through an agency? For PT's here that currently go this route, what equipment do you have on hand? Do you rent or buy? I think that the field is trending towards both a cash pay model, and home health, due to declining insurance reimbursements, cost of care, and convenience for the patient.

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I am in HH. Have therabands + light barbells & ankle/wrist weights on hand.

You'll need to be in a relatively affluent area for the cash pay model to work. And make sure you have good malpractice insurance if you're going solo.

Edit to add: Also check for potential non-compete/conflict-of-interest clauses in the employee handbook of your day job.
 
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I am in HH. Have therabands + light barbells & ankle/wrist weights on hand.

You'll need to be in a relatively affluent area for the cash pay model to work. And make sure you have good malpractice insurance if you're going solo.

Edit to add: Also check for potential non-compete/conflict-of-interest clauses in the employee handbook of your day job.

I am in the DC area. Do you go through a HH agency? If not, how do you find your patients, through word of mouth? Also, do you have a ballpark range for what malpractice insurance would cost, or can you direct me to where I can find that info? Thanks
 
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I lived in Fairfax County for several years. Nice place, but way too congested now...

As for your questions: I work in the HH unit of a hospital system. I'd say if you're striking out on your own, you'll have to market yourself to find patients. To be perfectly frank, I don't think it'll be easy at first: if I were to pay out my own cash for a PT and have $0 reimbursement from my insurance, I want someone seasoned and with lots of experience, and not a new grad. I have no idea how much malpractice insurance costs, check the APTA website as I am sure there'll be links there.
 
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I am looking to get into private pay home health PT as a source of supplemental income during evenings and weekends. My question is, is this something that you typically have to go through a HH agency for? Because as I understand, that is typically for patients going through their insurance (typically Medicare, Medicaid, managed care, etc.)

If I'm going with cash patients, am I able to do that without going through an agency? For PT's here that currently go this route, what equipment do you have on hand? Do you rent or buy? I think that the field is trending towards both a cash pay model, and home health, due to declining insurance reimbursements, cost of care, and convenience for the patient.
jbil has good advice re: liability and potential non-compete clauses in your current contract.

Are you trying to attract the traditional home health clientele, or are you essentially looking to provide PT to patients that we might typically see in an outpatient ortho setting, but in their home rather than a clinic? If it's the former, I think you're going to have a tough time building a caseload. The latter may be a bit easier, as you could likely market yourself to the busy weekend warrior types who may not have time to get to the clinic during usual work hours. Also, if this is the scenario you envision, there's no way I would contract through an agency - they won't have access to the patients you want, and they will take a cut of what you make.
 
HPSO and Lockton are 2 companies that will write malpractice policies for PTs. There are probably others. I continue to find it shocking that PTs don't carry their own policy in addition to something your employer carries for you. In 25 years I have always carried a policy on my own. Cheapest protection I can get. I don't pay much - less then $200/year but some of my research and other faculty things aren't all considered "PT" so I am classified as part time. The policy does include my teaching in a PT program though as my state considers that "PT practice."
 
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jbil has good advice re: liability and potential non-compete clauses in your current contract.

Are you trying to attract the traditional home health clientele, or are you essentially looking to provide PT to patients that we might typically see in an outpatient ortho setting, but in their home rather than a clinic? If it's the former, I think you're going to have a tough time building a caseload. The latter may be a bit easier, as you could likely market yourself to the busy weekend warrior types who may not have time to get to the clinic during usual work hours. Also, if this is the scenario you envision, there's no way I would contract through an agency - they won't have access to the patients you want, and they will take a cut of what you make.

I am actually not a PT. I am looking to contract trainers for in-home PT, through a cash pay model. A lot of the outpatient ortho practices in my area are bursting at the seams; some are unable to accommodate new patients for more than 1x/week. Some people I've spoken to would prefer the convenience of rehabbing their injuries at home, as opposed to driving to a clinic, some have high copays/poor insurance coverage, etc.

I think that there is a market for it, and I know that many PT's are looking for supplemental income via home health patients. So my thinking is that it would be mutually beneficial for both therapists and patients.
 
I am actually not a PT. I am looking to contract trainers for in-home PT, through a cash pay model.

So, you wouldn't be treating the patients? You would be the owner of a corporation that contracts licensed PTs to provide physical therapy in the patient's home?
 
So, you wouldn't be treating the patients? You would be the owner of a corporation that contracts licensed PTs to provide physical therapy in the patient's home?

Yes, I'm looking to contract therapists for home health PT. I don't want to deal with insurance reimbursement and I live in an affluent area so I think it's a viable idea. I can't seem to get a clear answer as to what type of insurance I'd need; probably just professional liability insurance for my business, and the individual therapists would obviously have to be insured as well, I'm assuming.
 
I'm an independent PT contractor for home health agencies through a middle man. I do about 1-5 visits a week and get paid $65-75 per visit depending on insurance. I have my own liability insurance through HPSO for $249 a year. You would probably need general liability insurance in the millions in case a contractor hurts a client/patient.

For your ca$h based model to work, you would have to charge $80-100 per visit and so that you can make $10-20 per visit off the PT. Can your area handle that fee?
You can hire a trainer to do in-home training for cheaper but can't call it physical therapy unless you wanna get sued. Most PTs have full time jobs so scheduling visits might be a problem. Trainers are more flexible with their time.
 
I'm an independent PT contractor for home health agencies through a middle man. I do about 1-5 visits a week and get paid $65-75 per visit depending on insurance. I have my own liability insurance through HPSO for $249 a year. You would probably need general liability insurance in the millions in case a contractor hurts a client/patient.

For your ca$h based model to work, you would have to charge $80-100 per visit and so that you can make $10-20 per visit off the PT. Can your area handle that fee?
You can hire a trainer to do in-home training for cheaper but can't call it physical therapy unless you wanna get sued. Most PTs have full time jobs so scheduling visits might be a problem. Trainers are more flexible with their time.

I have been doing in-home personal training in the area for ~5 years and typically charge $70-90 for a 1-hour session. I know more experienced personal trainers in the area that charge upwards of $100. If a trainer can charge that fee, I don't see why a PT wouldn't be able to. What is your rate for the initial eval? I've been quoted for around $150 for a 60-minute eval, and $80-100 for the follow-up sessions (45 mins each), depending on the nature of the patient's injury(ies).

Also, I'm trying to figure out if most home health PT's are bringing their own equipment, or if they're usually supplied rented/purchased equipment through the agency/company that contracts them. Obviously that would be another expense that I'd prefer not to incur. I'm thinking that evenings/weekends would be prime time for most PT's, however I know of some in my area that do home visits as their primary source of income, so perhaps they would be more flexible.
 
I have been doing in-home personal training in the area for ~5 years and typically charge $70-90 for a 1-hour session. I know more experienced personal trainers in the area that charge upwards of $100. If a trainer can charge that fee, I don't see why a PT wouldn't be able to. What is your rate for the initial eval? I've been quoted for around $150 for a 60-minute eval, and $80-100 for the follow-up sessions (45 mins each), depending on the nature of the patient's injury(ies).

Also, I'm trying to figure out if most home health PT's are bringing their own equipment, or if they're usually supplied rented/purchased equipment through the agency/company that contracts them. Obviously that would be another expense that I'd prefer not to incur. I'm thinking that evenings/weekends would be prime time for most PT's, however I know of some in my area that do home visits as their primary source of income, so perhaps they would be more flexible.
One issue you may run into is that people are used to PT being covered by insurance, and they are used to paying out of pocket for personal training. So, they may very well be willing to pay for personal training, but may be more reticent to pay out of pocket for PT.

You need a lawyer to help you set up and S-Corp and to advise you on what type of insurance you need to carry.

My experience in home health is that most PTs are given some minimal equipment - essentially a goniometer, some theraband, company paperwork to document the visit, reflex hammer, etc. Would probably want a stethoscope and blood pressure cuff as well.

The numbers you're talking about are similar to what I was paid in the Chicago area.
 
One issue you may run into is that people are used to PT being covered by insurance, and they are used to paying out of pocket for personal training. So, they may very well be willing to pay for personal training, but may be more reticent to pay out of pocket for PT.

You need a lawyer to help you set up and S-Corp and to advise you on what type of insurance you need to carry.

My experience in home health is that most PTs are given some minimal equipment - essentially a goniometer, some theraband, company paperwork to document the visit, reflex hammer, etc. Would probably want a stethoscope and blood pressure cuff as well.

The numbers you're talking about are similar to what I was paid in the Chicago area.

Thanks for the feedback. I have already set up an LLC. I have one contact that does home health PT full-time, and is interested in working with me. She works primarily with therabands and brings her own equipment on visits. She also has contacts in the area, that do home therapeutic massage, which is another service I'm looking to market.
 
Hey Daniel,

Let me know how everything is going with Home Health. I am a new Pt student starting school in a few weeks and am interested in Home Health. I wanted to know if you have looked into working for an Agency at all (I know you are primarily interested in starting your own), and if so what was the pay they offered you. I live in AZ and by looking at some current positions that are hiring, they are paying $95 dollars per visit. Also, do you think its feasible to do 35 visits a week? Working 50-60 hours per week? Let me know.
 
Also, do you think its feasible to do 35 visits a week? Working 50-60 hours per week? Let me know.

35 is the max I would do. You would have to work at least one weekend day to do that. Six a day is a good case load, especially if you're opening cases. 50 hours a week is the max you should do. Burnout is a real problem in this industry.
 
I see. So other than home health, what are some high paying settings within PT? Travel PT?
 
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