A medical fitness program addresses prevention, health-risk reduction, and an improved lifestyle. It is a wellness — not sickness — program. Trying to get it covered underneath your patients’ insurance is a hassle — not to mention bad business for you!
That’s why I highly recommend that you pursue a cash-based revenue stream and not try to find clever ways to bill your patient’s insurance plans. Not only do you open yourself up to medical necessity justification issues, you create even more dependency on third party payers with built in limitations and caps on fees and covered services.
Yes, you may have heard that some of your peers work the system and provide insurance-based exercise programs. Yes, they’re probably making some money, too. But remember: they’re also creating more dependency on insurance reimbursement, and maybe even a few nightmares for their practices.
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