Gold-plated PT

I’ve had the good fortune of doing several months of physical therapy for my knee at three different locations over the past 15 months. Each location did 30-minute appointments.

Cigna paid Harvard Vanguard $65 for each visit. I believe that Harvard Vanguard was using billing codes for 15-minute visits, even though it should have been 30 minutes.

Cigna paid Spaulding Rehab $130 for each visit. I believe that Spaulding Rehab was using billing codes for 45-minute visits, even though it should have been 30 minutes.

Cigna paid MGH $315 for each visit. I have no idea how they are billing.

Harvard Vanguard had a single physical therapist, and had no equipment or ice that I could use before or after my appointment. Spaulding had a physical therapist and a PT student who worked as a team, but I don’t believe they’re supposed to bill for the PT student. Spaulding often had me stay with ice (but no people) for 15 minutes after my appointment. MGH has a ton of equipment and ice that I can use before or after my appointment, and after the 30-minute appointment with the physical therapist I sometimes get handed off to a PT assistant to show me a few home exercises, print out notes, and answer questions. But the billing doesn’t seem to vary based on whether there is any time with the PT assistant. So while the relative prices are in the same order as the amenities, they are not proportional in any real sense. For the cost of a single 30-minute MGH visit, I could pay for a 60-minute Harvard Vanguard visit, a month of membership at a fancy gym, a 90-minute massage, and quite possibly a nice dinner out. This seems a little nutty.