Hey John, I do a fair amount of this in Ohio. I am an out of network provider. So I provide a physical therapy evaluation, if it meets the need for skilled physical therapy they have the option to submit it to their insurance for out of network reimbursement. If the need for service isn’t medically necessary for insurance coverage you should be able to charge cash as a wellness service. I don’t have contracts to worry about but if you are a in network provider you need to check with the provider to see if there is anything in the contract about charging the patient cash without the option to submit to insurance.

    I do a regular evaluation with my dry needling / wellness patients and document the same way.

    I obviously don’t know the direct access rules in Illinois so you should connect with a legal expert for specifics there.