BlueCross BlueShield of SC
Insurance.
Vertex PT Specialists is in-network with the following insurance plans:
Vertex PT Specialists is in-network with the following insurance plans:
Out-of-Network Physical Therapy and Insurance Reimbursement
At Vertex PT Specialists, we believe quality care should be accessible—whether we are in-network with your insurance provider or not. If we’re out-of-network with your insurance plan, you still have flexible options to receive treatment and potentially be reimbursed for your out-of-pocket costs.
What Happens If Vertex PT Is Out of Network?
Even if we’re not in-network with your insurance, you can still receive care at our clinic. Many patients choose to pay our affordable self-pay rates and submit for reimbursement directly through their insurance company.
After each visit, we’ll provide a superbill—a detailed receipt that includes all required billing and treatment codes.
To request reimbursement:
- Download a claim form from your insurance provider’s website.
- Submit the form along with your superbill.
Reimbursement rates vary, but many plans cover 40–80% of your visit cost. We recommend calling your insurance company and asking:
“What is my out-of-network reimbursement rate for physical therapy?”
Why Are You Out-of-Network With Some Insurance Companies?
We intentionally remain out-of-network with certain providers so we can continue offering one-on-one, individualized care—without the limitations that often come with large insurance networks. This allows us to:
- Spend more time with each patient
- Avoid high-volume, rushed care models
- Prioritize outcomes over quotas
If you have questions about your specific insurance plan, we’re happy to walk you through your options.
Do I need a referral from my physician for physical therapy?
No referral is needed in most cases. South Carolina is a direct access state, which means you can begin physical therapy without a physician’s referral.
Medicare beneficiaries, who are still required to have a referral or signed plan of care. If you’re a Medicare patient, we’re happy to help coordinate this for you.
To learn more about how direct access works in South Carolina, visit our Direct Access to Physical Therapy page.
Still Have Questions?
We’re here to help. Whether you’re in-network, out-of-network, or unsure of your insurance coverage, our team is available to walk you through your options and help you get the care you need.
Contact us today to verify benefits, schedule your first visit, or learn more about our cash-based options.
Patient Forms.
Save time and complete these forms online:
If you prefer to download and print,
use the following links:
Consent to Treat
Medical History Questionnaire
Consent to Communicate
Additionally, if you are receiving dry needling or are interested in receiving dry needling, please complete the following document:
