State Boards Are Coming for PT Packages

Can cash-pay physical therapy clinics sell packages?

In this episode of PT Breakfast Club, Tony Maritato, Dave Kittle, and Jimmy McKay react to recent discussion around state PT boards in North Carolina and Texas questioning whether cash-based, self-pay, or direct-pay physical therapy clinics can sell discounted treatment packages or collect payment for services that have not yet been delivered.

The crew breaks down the tension between consumer protection and business reality. Are these rules protecting patients, or are they limiting access, punishing business innovation, and forcing clinics into awkward workarounds?

Jimmy clarifies the difference between APTA chapters and state boards, while Tony and Dave talk through what this could mean for practice owners, patients, cash flow, refunds, accountability, retainers, memberships, and episode-of-care models.

Then the episode shifts into a six-pack referral draft: who should PT clinics build relationships with besides the obvious physician offices?

The picks include personal injury attorneys, youth sports coaches, private-pay nursing companies, gym owners and group fitness communities, wheelchair and medical equipment companies, and massage therapists. The crew closes by coming back to physicians with a better approach: stop leading with your credentials and start removing problems from their day.

The takeaway: whether you are selling cash-pay care or building referral relationships, the real work is understanding incentives, trust, risk, and the person on the other side of the transaction.