Do you take insurance?
No--Starting January 1, 2026, we will be transitioning to a fully self-pay service. All of our patients will be offered an invoice (aka "superbill") upon request that they may submit to their insurance provider for reimbursement. Per CMS guidelines, we will no longer be able to treat patients for Medicare-covered PT and OT, but we will be offering wellness and lifestyle packages focused on pain management, mobility, and overall health. These are not billed to Medicare and are available at transparent, self-pay rates.
Why are you transitioning to self-pay?
There are so many benefits to the patient and practice by adjusting our service model to self-pay! In addition to having direct access to our providers (no referral needed), there are no therapy caps, no visit limitations, no delays in insurance approvals, and no pre-authorizations requirements. All sessions are guaranteed to be one on one for a full 60 minutes (no groups or shortened sessions). Additionally, we can continue to offer telehealth services, which therapists are no longer able to provide under CMS rules.
Do I need a referral from my doctor?
No! Starting January 1, 2026, patients will be able to access our services directly without any referral from a provider.
Where do you treat patients? Do I have to live in Maryland?
Our therapists treat in the clinic, the home, or via telehealth, depending on patient location. For therapy services, all patients must live in Maryland. However, anyone nationwide can participate in our Wellness Programs via telehealth.
Do other therapy providers do what you do? Can't I get pain treatment from other providers?
Specialty Pain Management Services remains the only provider in the state and region specializing exclusively in pain management through physical and occupational therapy. Our practice delivers nationally and state-recognized, award-winning care led by an expert in pain management. SPMS is leading the way in providing innovative, evidence-based care that makes a lasting difference. Our patient outcomes say it all--our patients score higher on the Pain Self Efficacy Scale than the national average (10 points); gain greater independence with less reliance on caregivers per the Self-Assessment of Roles and Abilities scale (-11 points); and reduce their average day to day pain by 2 points or greater. No other practice in the region can say the same!
I am a Medicare patient. Why can't I get PT and OT through you?
According to the Centers for Medicare & Medicaid Services, physical and occupational therapists who are non-participating providers may not provide services that are covered under Medicare. However, non-participating providers can offer services that are not covered under Medicare including wellness, prevention, and long-term maintenance. Therefore, we will be able to offer programs focused on these three services (wellness, prevention, and long-term maintenance) at transparent, self-pay rates. Currently, we are offering 6, 8, and 10 session packages (see "Wellness Programs" for more information).