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Our user asked: "I am a physical therapy student and was wondering "Can physical therapists charge different amounts for the same treatment to different insurers?" I've been trying to find an answer with a citation but have not been so lucky. Please help!"
Ask a PT Response: "Depending on the contract with the insurance company, reimbursement/payment can vary among the various insurance companies. I've contacted the APTA and am waiting to hear back from them to see if I can get a citation or something in writing for you as well. "
According to the APTA website under the reimbursement section: "Different charges for the same service -- a provider may legally use multiple fee lists depending on insurer. Certain contracts with payers may require that providers charge them less than other insurers. While in most situations it is legal and ethical to use multiple fee lists, it is administratively complex. Please refer to the article, http://www.apta.org/AM/Template.cfm?Section=Coding&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=15977 - "Different Charges, Same Service" for additional information."
You can access the remiander of the article from the APTA website. However, you do need to be a member to access these articles.
http://www.apta.org/AM/Template.cfm?Section=Home&Template=/MembersOnly.cfm&ContentID=22288 - http://www.apta.org/AM/Template.cfm?Section=Home&Template=/MembersOnly.cfm&ContentID=22288
http://www.apta.org/AM/Template.cfm?Section=Coding&Template=/MembersOnly.cfm&ContentID=49079 - http://www.apta.org/AM/Template.cfm?Section=Coding&Template=/MembersOnly.cfm&ContentID=49079
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