CONTROL PANEL

Ignorance of Medicare Laws on
Cash-Pay PT Services
Could Leave You Defenseless 
AND Missing Huge Opportunities

Whether you are:

  • a veteran practice owner who participates with Medicare
  • a hybrid practice owner with Non-Participating status
  • a Cash-based practice owner not enrolled in Medicare
  • a physical therapist hoping to become any of the above

very few seem to know when and if they can take private-payment from Medicare beneficiaries.

The answer to this question actually changes based on a large number of factors, which are all explained in this eBook.

The Vital Things You Will Learn
in Just the FIRST HALF of This eBook:

Key Facts & Common Misconceptions

  • The 3 possible relationships a physical therapist can have with Medicare, which affects every decision you make surrounding this topic.
  • The reason a "Non-Participating Provider" is not the same thing as "opting out" of Medicare.
  • Why being a "Non-Participating Provider" is not the same thing as having no relationship with Medicare.
  • Why being non-enrolled or un-enrolling in Medicare is also not the same thing as "opting out" of Medicare.

Coverage Criteria & Mandatory Claims

  • The "Mandatory Claims Submission" law and how it affects your ability to provide cash-pay services to Medicare beneficiaries
  • The ONE exception the Mandatory Claims Submission law and how this exception can significantly change your ability to take self-payment from a beneficiary
  • How your specific relationship with Medicare dictates when/if you are able to provide covered services on a self-pay basis
  • 3 reasons why services are not covered by Medicare, and the scenarios in which covered services may become non-covered

Therapy Cap, Maintenance Care, ABNs, & Cash-Pay Opportunities

  • How meeting the Therapy Cap may or may not change your ability to collect self-payment from the beneficiary, and the process you should follow in doing so.
  • The key factors you must know to determine when you can take cash-payment for "Maintenance Care"… sometimes you can and sometimes you can't.
  • How the 2009 HITECH Act and the 2013 HIPAA Omnibus Final Rule may or may not have created opportunities to treat beneficiaries on a cash-pay basis.
  • When you should use an Advance Beneficiary Notice (ABN) versus a Private Contract if you'll be collecting private payments from beneficiaries.
  • The correct process for using an ABN when normally-covered services may no longer be covered due to lack of medical necessity.
  • Key information needed for ABN use with patients who have met the Therapy Cap.

Pricing Legalities and Guidance on Discussing this Topic with Patients

  • The checklist of “talking points” you’ll need when discussing payment with prospective patients as a Non-Participating provider
  • Crucial points to consider as a non-enrolled provider discussing treatment and payment with prospective Medicare-aged patients
  • The laws and regulations surrounding the Pricing of your services and the penalties you can incur with non-compliance
  • How those pricing rules change based on your relationship with Medicare, whether or not the services are normally covered and your compliance with the Physician Quality Reporting System (PQRS) and Electronic Health Records (EHR)

“Jarod Carter has developed the quintessential guide to navigating Medicare for the P.T. in private practice. Whether you are cash-based or not, this book is essential for having a place to look up the facts, questions and answers we all need to know to steer carefully through the Medicare guidelines. It has been carefully researched, referenced and written by a thoughtful expert practitioner who has taken his time, with professional colleague feedback, to develop the first ‘P.T. Medicare handbook of its kind.’ It has been not only a pleasure to read, but also useful to someone with 36 years of professional and private practice experience. Well done, Dr. Carter!”

Larry Greenberg, PT, MS, M.Ed.
Martha’s Vineyard, Massachusetts

"Whenever I have any questions regarding cash-based physical therapy I turn to Jarod Carter …
and especially when it comes to Medicare and cash-based PT.
He does an amazing job sharing his expertise and clearing up a subject that is complicated and confusing. Lenny Macrina and I have leaned on Jarod several times in the development of our model at Champion PT and Performance, and this book has been an incredible guide for what we can and can't do when it comes to Medicare beneficiaries and our cash-pay services. I can't recommend it enough!"

 

Mike Reinold, PT, DPT, SCS, ATC, CSCS
Boston, Massachusetts

You could be LOSING $10,000's by NOT Knowing how to legally implement Cash-Pay Medicare programs in your practice ... Not to mention RISKING $10,000's if you get caught doing it wrong!

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     The Audio-Book

The entire eBook read to you ... Learn and reinforce all components of this confusing topic while on the go.

                         $97

BUY NOW
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        The eBook

Discover every detail and have direct links to all the relevant parts of the law & resources
You and Your Attorney Need

                        $147

BUY NOW
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The Recorded Webinar

Watch this presentation to get the main points and must-know concepts in less than 45 minutes.


                        $47

BUY NOW
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Get All 3 of these amazing products for the low price of $197   (a $100 DISCOUNT!)

... And save $1000’s in lost revenue and wasted time that comes from NOT knowing how to effectively work with cash-pay Medicare patients!

 

YES, SEND ALL 3 RIGHT NOW >

100% SATISFACTION GUARANTEE

NOT SURE? SCROLL DOWN TO READ ABOUT YOUR BONUSES

BONUS! Over 20 Pages of
Frequently Asked Questions

There is ALSO a Q&A section (in the eBook and Audiobook) that answers all the other most common and obscure questions I've received on this topic over the past 5 years ...
Helping Practice Owners make $1000's by Safely
accepting Cash-Pay Medicare patients .

Some of those questions include:

  • How do I differentiate between covered "skilled physical therapy" and non-covered services like "wellness," "fitness," and "prevention"? What does a compliant cash-pay fitness or wellness program look like?
  • What if a patient is only signed up for Medicare Part A and does not have part B or C? Some of my Medicare-aged patients have Part A, but maintain private insurance coverage for their outpatient healthcare (via their un-retired spouse’s work benefits). In this scenario, can we provide outpatient PT services on a private-pay basis?
  • I am not an enrolled Medicare provider. I have a prospective patient who is a Medicare beneficiary and is currently getting PT at another clinic, which participates with Medicare. He would like to see me as well on a cash-pay basis to receive more specialized and longer therapy sessions. Is this okay?
  • If I drop my provider status and only see Medicare beneficiaries for private-pay services, am I still required to document in the same way I was as an enrolled provider? How do treatment documentation requirements change?
  • Can practices have success being out-of-network with all 3rd Party Payors except for Medicare?
  • How do I find out if a patient has met the Therapy Cap?
  • Am I under the same limitations and regulations for retired military patients with TRICARE coverage, who want to see me on a cash-pay basis?
  • Can I change my Medicare-provider status? Exactly how do I do so?
  • What is the best Medicare-provider relationship for me and my practice?
  • If a patient is Medicare-aged but has a private insurance as their Primary, and Medicare as their Secondary insurance, can we see these patients on a private-pay basis just like we do with Non-Medicare patients who are privately insured?
  • What about patients with Medicare ADVANTAGE Plans (Part C)? Since they have signed their benefits over to a private insurer can I see them on a private-pay basis as if they were like my Non-Medicare patients?

Want an Attorney to help guide you through
these murkey legal waters? Great! You Should!
BUT
Most attorneys DON'T KNOW about this
obscure but vital part of Medicare Law.

Provide Your Attorney with a Guidebook that Directly Links to
Every Part of the Law They Will Need
to Help You Make the Best Decisions ...

Saving them Time and
SAVING YOU $1,000's IN LEGAL FEES

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     The Audio-Book

The entire eBook read to you ... Learn and reinforce all components of this confusing topic while on the go.

                         $97
 

BUY NOW
Card image cap

        The eBook

Discover every detail and have direct links to all the relevant parts of the law & resources
You and Your Attorney Need

                        $147
 

BUY NOW
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The Recorded Webinar

Watch this presentation to get the main points and must-know concepts in less than 45 minutes.


                        $47
 

BUY NOW
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Get All 3 of these amazing products for the low price of $197   (a $100 DISCOUNT!)

... And save $1000’s in lost revenue and wasted time that comes from NOT knowing how to effectively work with Medicare!

 

YES, SEND ALL 3 RIGHT NOW >

100% SATISFACTION GUARANTEE

If you don't feel like these products are worth every penny you spent, I'll give you a full refund. No questions asked.

What Your Colleagues Are Saying About
Medicare and Cash-Pay PT

"Dr. Jarod Carter's eBook 'Medicare and Cash-Pay Physical Therapy' has given me the tools to not only understand Medicare, but to make it work in my business. Before reading this book I was unsure of many things regarding Medicare and my cash-based business, so I just didn't see Medicare patients at all. Now I have the understanding and confidence to see these patients without fear or stressing about what I can and can't do."




 

Dr. Allyson Sunderman, PT, DPT, PYT-C
St. Augustine, Florida

"Jarod Carter's ebook 'Medicare and Cash-Pay Physical Therapy' is a very in-depth explanation of an extremely complex and confusing subject. He has painstakingly researched and answered virtually every conceivable scenario that a private practice owner need consider when dealing with Medicare patients. He provides countless resources for anyone wanting a more detailed explanation of the Medicare system. All in all, a tremendous resource for anyone in or contemplating a cash-based private practice and what their options are for dealing with Medicare patients."

David A. Wilderman, PT, DPT, MS
Wilmington, Delaware

Are you tired of having your documentation scrutinized and having to deal with the confusing and frustrating maze of Medicare regulations?

  • Do you want to get out of the system so you can focus on patient care and growing your business rather than on paperwork?
  • Maybe you'd just like to establish some cash-pay programs for your Medicare patients. Do you know how to do so in accordance with the law?
  • Want the FREEDOM to treat your patients the way you know is best, and not have to worry about what will be reimbursed?

You are not alone!
Physical therapists and practice owners just like you have found the answers they are looking for within this eBook.

“With all of the confusion around cash-based practices treating Medicare patients, I had gotten to the point where I was just turning these patients away altogether. After reading this book I’m now confident that I understand how to navigate this patient population. Jarod leaves no stone unturned and no question unanswered. It’s a must-read for physical therapists in the cash-based world.”

Steve Cuddy PT
Austin, Texas

"Jarod has clearly made the rehab-version of Medicare’s ‘Cliffs Notes’ here. Seriously, if you are a clinic owner and/or treat Medicare clients, this guide is as simplified as the convoluted Medicare system can get, especially when collecting cash from Medicare clients. I read a lot of info from Jarod’s blog while opening my practice 2 years ago, and it worked like a charm.”
 

Kevin Schmidt, PT, MSPT, CMP, Cert. Bike PT
Portland, Oregon

It's Time to Stop Guessing and Hoping ...
It's Time to Drop Confusion and Fear ...
It's Time to Get Clear on How You Can Capitalize on
Enormous Cash-Pay Opportunities
and Keep your Practice Safe & Thriving!

Card image cap

     The Audio-Book

The entire eBook read to you ... Learn and reinforce all components of this confusing topic while on the go.

                         $97

BUY NOW
Card image cap

        The eBook

Discover every detail and have direct links to all the relevant parts of the law & resources
You and Your Attorney Need

                        $147

BUY NOW
Card image cap

The Recorded Webinar

Watch this presentation to get the main points and must-know concepts in less than 45 minutes.


                        $47

BUY NOW
Card image cap

Get All 3 of these amazing products for the low price of $197   (a $100 DISCOUNT!)

... And save $1000’s in lost revenue and wasted time that comes from NOT knowing how to effectively work with Medicare!

YES, SEND ALL 3 RIGHT NOW >

100% SATISFACTION GUARANTEE

Still not sure?  Find answers to your questions below

Frequently Asked Questions

Is this book geared solely towards cash-based practices, or is it for any type of PT practice? I participate with Medicare and do not want to change my provider status. I would like to know when it is and isn't allowed to take cash-payment when a beneficiary requests to pay privately, hits the Therapy Cap, joins my fitness program, etc.

This eBook is geared toward every type of physical therapy practice, and specifically addresses the rules and regulations pertaining to beneficiary private payment based on ALL 3 relationships a PT can have with Medicare. All the topics listed above are explained in detail for Participating providers as well as Non-Participating providers and non-enrolled providers.

I usually don't spend more than $25 on a book. What makes this one different and worth more than that?

Practice owners really need to know this information in order to not only avoid fines and disciplinary actions but also to avoid missing opportunities to treat this population on a cash-pay basis. I have gathered the information in this eBook from multiple sources over the course of 5 years. I can't imagine anyone being able to gather all this information with fewer than 25 hours of research/emails/phone calls, etc. So, as a businessperson, you have to ask yourself if your time is worth more than $2 per hour. Since your time is obviously worth far more than that, this eBook is a valid expense and great bargain - not to mention the hundreds/thousands of dollars it could save you in legal fees by having a guidebook to give your attorney with links to all the applicable parts of the laws they will be evaluating.

Does this eBook apply to related professions such as occupational therapy, speech pathology, chiropractic, or medicine?

This eBook is specific to the field of physical therapy. There may be a lot of cross over and matching regulations (especially with OT and SLP), but I have not researched those and cannot guarantee that all the rules are the same. The rules are most certainly different for physicians since they are on the list of practitioners who can "opt out" of Medicare. However, this eBook may still provide guidance to related professionals in terms of what questions to ask, where in Medicare regulations/manuals they can find answers, the overall structure of Medicare and the private-pay realm, etc.

I'm interested in having a cash-based practice someday, but it won't be for a while. Should I wait till I'm ready to start the practice before I buy this book and learn this information?

The preparation for starting a private practice should begin long before you see your first patient (if possible). This is a huge subject that isn’t easily grasped in a short period, so I would suggest familiarizing yourself with it as soon as possible. Certain segments of this eBook will also help you decide what relationship you want to have with Medicare and help you plan what cash-pay services to develop in your new practice. Having a clear idea of these relationships and potential opportunities can have a huge effect on your business plan, so I would suggest learning this material as soon as possible.

Shouldn't I be getting these answers from an attorney?

Absolutely! Some questions are best answered by an attorney, but even most healthcare attorneys are not well versed in this particularly obscure topic within the complicated world of Medicare law. This eBook is not a substitute for legal counsel, but it will educate you on the overall structure and laws surrounding this topic, and the different viewpoints of legal authorities and entities involved in it.

One of the things that makes this eBook so valuable is that it provides the resources, laws, and links to information an attorney will need to help you make the best decisions based on your specific situation ... likely saving them hours of time and saving you thousands of dollars.

If you want to be fully protected and informed, you will still need legal counsel, but this eBook is a great place to begin educating yourself (and your attorney) on all sides of Cash-Pay Physical Therapy and Medicare.

What's Your Plan for the Future?

Reimbursements for our services are on a steady decline. The exit of the Baby Boomers from the workforce will only further strain an already fragile system. As this happens and further cuts to provider payments are necessary to keep the system afloat, “tertiary” services like physical therapy will take some of the biggest hits.

Whether or not you want to participate with Medicare, all practices will need to find ways to increase revenue that is not based on third-party payer reimbursement. This is why the information in this eBook is so important for all current and future physical therapy practice owners and staff.

Do not wait until your back is against the wall before you try to figure out how to legally increase your cash-based revenue. And definitely don't guess whether or not you are compliant with current regulations. Get the whole story, gain clarity and move forward with confidence.

Learn how to capitalize on cash-pay opportunities without breaking laws and endangering your practice.


The penalties for noncompliance in this arena are enough to cripple most small-to-medium-sized practices.

Educate yourself today and make sure your practice continues to thrive in the future.

Card image cap

     The Audio-Book

The entire eBook read to you ... Learn and reinforce all components of this confusing topic while on the go.

                         $97

BUY NOW
Card image cap

        The eBook

Discover every detail and have direct links to all the relevant parts of the law & resources
You and Your Attorney Need

                        $147

BUY NOW
Card image cap

The Recorded Webinar

Watch this presentation to get the main points and must-know concepts in less than 45 minutes.


                        $47

BUY NOW
Card image cap

Get All 3 of these amazing products for the low price of $197   (a $100 DISCOUNT!)

... And save $1000’s in lost revenue and wasted time that comes from NOT knowing how to effectively work with Medicare!

 

YES, SEND ALL 3 RIGHT NOW >

100% SATISFACTION GUARANTEE

100% MONEY BACK GUARANTEE - NO QUESTIONS ASKED

About the Author

Jarod Carter PT, DPT, MTC

In 2005, Jarod earned his Doctorate in Physical Therapy from the University of St. Augustine. Since then he has continuously sought out skilled mentors and learning opportunities in manual therapy and business alike. He worked in both insurance-based and private-pay practices before opening Carter Physiotherapy in Spring 2010, a cash-based clinic where he provides an hour of one-on-one care in every treatment session. Via creative marketing and his reputation for producing fast results, his patient schedule was full within 6 months of opening his cash-based practice. In the fall of 2011, he released his first book My Cash-Based Practice and has been blogging, podcasting, and speaking on all aspects of the out-of-network practice model ever since. Jarod enjoys surfing, swimming, travel, and time with family. He married the girl of his dreams in April of 2015.

Still not sure if you want to buy the eBook? Okay, but at least get the first 22 pages for free by clicking the button below...

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