cash-based PT services

Looking to grow your physical therapy practice and increase profitability? Adding a cash-based PT product or service to your standard offerings can greatly add value to your practice and your patients.

In a recent Grow Your Practice Podcast episode, several physical therapy practice owners spoke about their experience adding cash-based services.

We took the best insights from that conversation to develop this article. Read on to learn about the benefits and challenges of adding a cash based PT service in your practice. Discover three of our favorite technologies that practice owners are selling as a cash-based service today. Gain an understanding of the process for implementing a cash-based service in your private practice.

Why Add a Cash Based PT Service?

Increase Profitability

Physical therapy clinics often operate with tight margins. In the last few years, margins have been squeezed further by declining reimbursements and rising costs. Many practices are operating with substantial financial risk. Some have had to close for good or sell prematurely.

Whether you’re looking to reduce financial risk or stay ahead of the curve, adding a cash-based PT service is a proven way to become more profitable.

cash-based PT

Differentiate Your Practice

Have stiff competition from local practices and hospitals? Having additional forms of treatment can be the differentiator that makes your practice stand out from the crowd.

Enhance the Patient Experience

Medical devices can complement physical therapy treatment to offer improved patient outcomes. Some patients will experience relief or another desired outcome within a single visit, making them more likely to return and recommend your services.

Increase Lifetime Patient Value

Lifetime Patient Value is the amount of revenue an individual patient generates throughout their journey with your practice. It’s more cost-effective and efficient to maximize lifetime patient value than to attract new patients. There are two ways that adding a cash based PT service can help you increase lifetime patient value.

1) You can increase the value of your plan of care. If you’re at maximum capacity or have experienced staffing challenges, then adding a cash-based service could be a great way to increase revenue without having to increase your patient volume.

2) You can increase past patient reactivations. Adding a cash based PT service presents an opportunity for you to reengage past patients and attract them back to your clinic.

3 Cash-Based Services for Private Practices

Cash-based PT services should add unique and discernible value to your patients. If your patients feel a difference within just a few treatments, the value of this service will exceed its costs. For this reason, selecting a service that offers exceptional patient health outcomes is important. Consider these outstanding options:

LightForce® Therapy Lasers and Focused Shock Wave Therapy

cash-based PT
Image courtesy of Enovis™ Chattanooga® LightForce®

Enovis™ Chattanooga® LightForce® offers numerous medical devices that help improve patient outcomes. Two of their most popular devices are the LightForce® Therapy Lasers and Focused Shock Wave Therapy. LightForce® Therapy Lasers are used to treat chronic and acute musculoskeletal conditions as well as post-activity recovery. As a non-drug, non-surgical solution, LightForce® Therapy Lasers have been proven to reduce pain without the side effects of medication.

Focused Shock Wave therapy is another non-invasive treatment option for patients with trapezius muscle pain, shoulder pain, elbow pain, knee pain, achilles tendon pain, or plantar and heel pain. It can treat large areas in a short treatment time.

With both devices, patients often report noticeable pain reduction with just a few treatments.

Many practice owners in the Breakthrough community have adopted these technologies with great results.

Practice owner Tony Cere has added $300,000 in annual cash-based revenue. “Patients will come in for the laser, and turn into physical therapy patients,” he said.

According to Tom Loyd, Practice Owner at Bryn Mawr Sports Therapy, “The Lightforce 40-watt laser generates improved patient outcomes and adds an accessory form of income.”

The Neubie by Neufit

cash-based PT
Image courtesy of Neufit

The Neubie by NeuFit is a direct current (DC) electrical stimulation device. It targets the nervous system to reset broken and blocked neural pathways. It can be used to reduce pain, restore function after neurological injury or disease, produce a faster path to recovery after an injury or surgery, and improve fitness and performance.

The unique value proposition that Neubie adds has demonstrated extraordinary revenue potential. For instance, a private practice owner in Tampa, Florida, Jason Waz, boosted monthly cash-based revenue at his practice from $8,000 a month to $50,000 a month by implementing the Neubie device. In fact, the first year he implemented Neubie, his revenue per visit improved by $15 per visit across all payers.

Jason even managed to have the best month in his 10-year history while moving locations, which he attributes to the value differentiator of the Neubie.

3D Running Technology From RunDNA

physical therapy
Image courtesy of RunDNA

RunDNA provides specific value to runners by combining technology and education to assess and improve their movement. The technology allows you to analyze patient movement, craft unique injury profiles, and create comprehensive plans for runners’ success.

If you’d like to attract more runners to your practice, RunDNA’s solution could be a great fit. It will enable you to attract your ideal patient and increase revenue per patient.

Challenges of Adding a Cash-Based PT Service

Any time you change your services or add a new one, you may encounter resistance as you guide your patients and staff through new protocols. As always, the goal is to maintain the highest standards of patient care throughout the process, which may require additional client and staff education measures. Your staff, in particular, will want to see evidence the technology works before recommending it to patients. Be prepared with research and evidence. If possible, give your staff an opportunity to trial the technology themselves.

Patient education is also critical. Some clients will be used to having insurance cover their treatment and may hesitate to pay for services directly. Ensure your staff clearly communicates the cost and value.

In addition, keep an eye on the services your competitors offer and industry trends. Stay updated on the latest treatments so you can quickly adapt to emerging technologies.

How to Effectively Implement Cash-Based Services

Effective change management starts with a plan. To get the most immediate value out of offering cash-based PT services, you should implement them strategically. Here are some key factors to account for:

  • Patient Experience: Determine how a new cash-based service offering would fit into your patient experience. Is it offered as a standalone service or as an add-on to the plan of care? Create a roll-out plan that offers a seamless patient experience for existing and new patients.
  • Target Market: To choose the right cash-based PT service, you need to identify your primary target market. Will this service help facilitate healing and recovery for the primary conditions you treat? Is there a willingness to pay cash for this type of treatment? You might be surprised to discover how many patients are willing to invest in solutions to improve their health and reduce pain. Consider asking your existing patient base or conducting a survey to gauge interest and willingness to pay.
  • Selling: Your patients don’t necessarily need a sales pitch, but they often need to be educated on the personal value they’ll get from a specific service. Train your staff on how and when to educate patients about your new offering. Consider including it as part of your recommended plan of care for new patients. You can also incentivize staff to encourage adoption.
  • Marketing: Run campaigns to past patients to spread the word about your new offering and encourage past patient reactivations. You can also run workshops for people in your community who could benefit from the treatment. Workshops can take place in the community by partnering with a local gym, employer, or other organization with a lookalike audience to yours. Alternatively, you can host an educational event at your practice or virtually. Promote it through your social channels, email, or online advertising.

Grow with a Community of Like-Minded Practice Owners

Strategically implementing cash-based PT services is one of the most effective ways to improve revenue per patient. However, this is just one aspect of increasing profitability so you can grow your practice, increase practice value, and leave a lasting legacy in your community.

Running a practice is harder than ever. Declining reimbursements, staffing challenges, and rising costs require owners to innovate and come up with creative solutions if they want to succeed.

Why do this on your own when you can learn from others?

You don’t have to reinvent the wheel and come up with new ideas by yourself. Many practice owners have achieved success and want to share their knowledge and experience with other practice owners to benefit our industry as a whole.

Introducing Profitability Under a Pressure: A Program Exclusively for Physical Therapy Practice Owners.

The program includes a course, weekly group calls, access to an online community of practice owners, and opportunities to attend in-person events with other practice owners facing the same challenges you are who are committed to finding solutions.

Click here to learn more and apply for Profitability Under Pressure.


One of the alarming metrics I share about Madden PT (my Private Practice) is in 2009, we hit an all-time highest ever of 154 New Patients referred by physicians, in one month.


Due to the changing healthcare environment (Hospital systems, POPTS practice come to mind), that number shrunk to 30 New Patients for us in March.

So we’ve gone on a progressive decline from 154 down to 30 in physician referrals.

Yet we’re busier than ever before…

Our income is better than ever before…

We’re seeing more ideal clients than ever before…

Our patient compliance and graduation rate is better than ever before…

And we continue to grow…

So What’s the Deal?

A month or two ago in the “Breakthrough Marketing Strategies for Physical Therapists and Owners” group on LinkedIn…another owner stated:

“We need referrals from doctors to stay in business… if we don’t have that, we might as well join them.”

(I’m paraphrasing, and unfortunately not giving the full context in the space provided here, yet I’m sure you get the point).

I’ll politely decline to agree with the comment, and here’s why.

In spite of operating in one of the most competitive healthcare markets in the U.S., my Private Practice continues to grow (we doubled profitability in 2013, over any other year in business).

So what’s the BIG Secret of how we continue to grow and expand in spite of shrinking referrals?


Acres of Diamonds

One of my favorite stories of all-time is Russell Conwell’s “Acres of Diamonds” (you can Google it and read it later).

In the story, a farmer sells his land and farm in Africa and spends the rest of his life desperately searching for diamonds, and dies broke and a failure.

Meanwhile the land that he sold, the farm, later was discovered to be on top of the largest diamond mine in the history of the world…

I’m not sure if the story is true or not.

It’s a good one though.

And it illustrates a point I believe many of us Physical Therapy Private Practice Owners miss…

We’re sitting on Acres of Diamonds, and don’t even realize it…


BIG Secret Revealed

In my Direct Access Marketing Training, one of the first things I share is the value of:

Your Past PT Patient List (Your Acres of Diamonds)

These people already know you.

They like you.

They trust you.

And now you’ve discharged then and maybe even encouraged them to never come back again…

M-I-S-T-A-K-E (and one I made for years).

In any industry, in any business, the #1 Asset of the business is the customer list AND the relationship of that business with their customers.

And as in other businesses, you can choose to:

  1. Ignore your patient list.
  2. Send them generic, meaningless B.S. that portrays, we hope, that we care about our patients…
  3. Or send them meaningful communication that allows that patient to continue to feel connected to us.


What Meaningful and Valuable Communication Can Do For You and Your PT Private Practice

Two weeks ago we hit an all-time high here at Madden PT, 17 Returning Patients in one week.

That’s 17 New Patients just from our past patient list.

Our team was pumped.

And you can do the same…

Staying in contact with your past patient list does several things:

  • Keeps you top of mind for their Physical Therapy needs…
  • Establishes you as an Authority, Celebrity and Expert (A.C.E.)
  • Makes it more likely they refer their friends and family to you…

And my favorite benefit, if you do this the right way.

They’ll come back years later and talk to you as though they’ve never left.

It’s pretty cool…

Like they’re part of your family.

(I cover step-by-step how I’ve done this at Madden PT for the past 10 years, in my Killer Marketing Training, only open to Private Practice PTs unfortunately, the enrollment period for the latest group of owners is closed as of this writing… we’ll be opening another Direct Access Marketing Course later this year).

***As an aside, by far your greatest Return on Marketing Investment (ROI) should come from your marketing efforts to your past patient base…NOT the unwashed masses of the general public.  Write this down…and reread it until it’s etched into your subconscious business mind.***

So How Do You Stay in Touch With Your Past PT Patients?

Well you have quite a few options when choosing how to stay in touch with your past patients…

If you’ve been following my blog, you know by now I’m a huge fan of Direct Response Marketers, especially Dan Kennedy.

For years, Dan taught a concept called “Market-Message-Media” match…meaning for your marketing to work, you need to match the right market with the right message using the right media.

So for our past patients and considering “Media”, here’s a few options:

  • Email
  • Snail Mail (including postcards, letters, and newsletters)
  • Facebook and other Social Media
  • Fax
  • Texting
  • Phone
  • Live communication, such as at an event…
  • Smoke signals…

You get the point…

So, which “Media” is most used by your past patients AND are they most likely to respond to?

(That’s what I would use, and what I share in the Killer Marketing Training).

On the negative side I dropped my Twitter efforts years ago, because my Target Market is not using Twitter.


OK, You Picked Your Media…Now What Do You Put in There?  What’s Your Message?

Again, due to the limits of space and time, I’m going to touch on this briefly…

I can tell you what your message should NOT consist of, at least from experience.

100% PT Jargon-filled, condition-related advice…

You know what I’ve found to work best?

Yes. Donkeys.


Recently in a bulletin we sent out to our past Patient List (a touch over 7,000 people), we did a cover story on the 3 Mini Donkeys we have on our farm…and the story of how one ends up with 3 Mini Donkeys: Haley, MoonBeam and Peppermint Patty (who is expecting in August, so make that 4 Mini Donkeys).

A little quirky…

A bit different…

BUT Crazy effective at building long term relationships with past patients (aka customers) who already know, like and trust us…

And WAY outside of the box of typical “marketing” you’d get from your PT.

At this point, it’s in your court…

Are you going to continue to rely on physician referrals 100% to grow your practice?

Even though you KNOW they’re being bought up by the local hospital system…or may be opening their own POPTS clinic in the future?

Or are you going to start working your past patient list?

Warming it up?

And eventually seeing them after their TKR, for your PT, even when the orthopedic surgeon says he wants them to go to the PT in his basement because they “communicate better” (even though we really know it’s because the ortho owns that clinic)?

So what’s it going to be?

If you’ve been following the full Patient Funnel…then you know we’ve covered 5 Steps so far:

  1. Lead Magnet
  2. TripWire
  3. Core Service
  4. Upsells and Cash Pay Services
  5. And now, the Return Path

Next time, I’ll be covering “Referrals”, and how we just hit a Highest Ever for New Patients referred by other patients in one week: 14.  (That’s for one clinic.)

That will be my last blog covering the Patient Funnel…

Do you have something you’d like to read about regarding Private Practice PT Marketing?  Hit the “Like” button and leave a suggestion below…

Also, as I mentioned earlier, my Killer Marketing Training Enrollment is closed as of this writing, and won’t open again for likely another 6 months.

BUT in the mean time, I do have a few tools I can share with you IF you’re a Private Practice PT or Private Practice Owner.

I put together a “Fix Your Funnel” package which includes:

  • “My Greatest Promotion Ever”…which is the step by step guide to a single day promotion we used at Madden PT which resulted in 65 New Patients in one day (October 29, 2013) and 50 New Patients PLUS a Waiting List (on November 4, 2014).
  • The Killer Testimonial Machine…which is how we’ve collected over 4,000 Patient Stories and Testimonials from our patients…this includes the “What to say”; the template we use…and what we do with the testimonial once it’s written by the patient.

Go here to check out the offer:

I’ll leave it up at least through the next month.

Hope this helps you,