John R. Astrab PT, DPT, OCS, MS, CSCS
We will not be accepting new patients from United Healthcare, effective January 1, 2019. Except for current United Healthcare patients and MEDICARE we are an out of network provider. We will continue to submit routine claims to your insurance, however we will not conduct any business with fourth parties including Managed Care Organization.
MEDICARE LIMITS ON PHYSICAL THERAPY SERVICES: Medicare law limits how much it pays for your medically necessary outpatient therapy services in one calendar year. These limits are called “thresholds”, “therapy caps” or “therapy cap limits”. Outpatient therapy “soft cap” limits for 2019 is $2,040 for physical therapy (PT) and speech-language (SLP) services combined. If the “soft cap” or “threshold” is reached and is still medically necessary, the service qualifies for an exception and a KX modifier is put into place. IT IS VERY IMPORTANT TO RECOGNIZE THAT MOST CONDITIONS WOULD NOT ORDINARILY RESULT IN SERVICES EXCEEDING THE CAP.
We remain one of the few clinicians in the area to offer treatment with a Class 3 Cold LASER and we remain one of the only providers in the area to schedule one patient per hour with one to one care by a Board Certified Physical Therapist.