Direct Pay vs. Insurance-Based Physical Therapy: What’s Best for Runners?

If you're a runner dealing with an injury, finding the right physical therapy approach is key to getting back to training without setbacks. One of the biggest decisions you'll face is whether to go with insurance-based PT or a direct pay model (also called cash-based PT).

At Steady State, we use a direct pay model, and we want to break down why this approach often leads to better results, faster recovery, and ultimately lower overall costs—especially for runners.

What’s the Difference?

Why Runners Benefit from Direct Pay PT

Most insurance-based PT clinics operate under strict reimbursement rules, meaning they can’t always treat runners in the way that actually gets them better. This leads to:

✅ Shorter, rushed sessions that don’t address your full movement patterns
✅ A focus on short-term pain relief instead of long-term performance
✅ Minimal strength training, even though it’s a key factor in injury prevention

With direct pay PT at Steady State, you get:

🏃 Individualized strength-based rehab to build resilience and prevent re-injury
🏃 Full-hour sessions with a PT who understands running biomechanics and run coaching
🏃 No wasted time with unnecessary treatments—just what works

Doesn’t Insurance Cover PT? Won’t Direct Pay Cost More?

It’s a common misconception that insurance saves you money—but for many runners, insurance-based PT actually costs more in the long run.

• Most runners have high deductibles ($1,000+), meaning you pay out of pocket for PT until you hit that threshold.
• Insurance-based PT often requires 2-3 visits per week, which adds up in copays. But beyond cost, this model also wastes a lot of time—because the care is less individualized, you need more frequent visits just to make progress.
• Many patients get surprise bills months later when insurance denies certain treatments.

At Steady State, you know your costs upfront—and because we focus on getting you stronger faster, you typically need fewer visits overall.

How to Use Out-of-Network Benefits

If you have out-of-network insurance benefits, you may be eligible for reimbursement — sometimes covering 60-80% of your care.

We provide you with a superbill to submit to your insurance company, and many of our clients receive a partial refund within a few weeks. This means you get high-quality care without the limitations of in-network PT, and still get financial support.

Why Runners Choose Steady State

Many runners come to us after trying traditional PT without success — realizing they need a different approach to truly heal and prevent future injuries. Investing in the right care upfront can save you time, money, and frustration in the long run.

Ready to take control of your recovery? Schedule a free 15-minute Discovery Call to see how Steady State can help you get out of pain and back to running stronger than ever.

Happy running!

-Kelton 

Dr. Kelton Cullenberg, PT, DPT