Becoming a Cash-Based (Pelvic) Health Practitioner: A Guide
By: Blog contributors Maggie Bergeron, MScPT; Doug Vestal, PhD, Owner of Freedom of Practice; Dr. Aaron LeBauer PT, DPT, LMBT, RYT; Editor: Nataliya Zlotnikov, MSc, HBSc∙Estimated reading time: 9 minutes

Becoming a Cash-Based (Pelvic) Health Practitioner

The healthcare industry is evolving at an unprecedented pace, and many practitioners are discovering a successful new path by transitioning to cash-based practices. In this model, patients pay directly for services without involving insurance companies, giving you greater control over your practice, schedule, and income. For those specializing in pelvic health, opportunities are even more abundant, as the demand for pelvic floor physical therapy continues to rise.

If you're a healthcare practitioner interested in making the jump to a cash-based practice, especially in pelvic health, this guide will help you navigate the essential steps, challenges, and rewards of this career path. Along the way, we will also sprinkle in a few Embodia features that are available to help cash-based practices be successful.

Included in this blog are tips from Doug Vestal and Dr. Aaron LeBauer.

Doug Vestal has had a cash-based pelvic floor therapy practice for over 10 years, and has personally mentored hundreds of practitioners starting cash-based practices (both within pelvic health and other specialties).

Dr. Aaron LeBauer is the host of The CashPT Lunch Hour podcast, owns a 100%, multi-therapist cash practice and is the creator of multiple online information products and membership sites in physical therapy business development, all six-figure earning businesses. In addition to that, he runs multiple private Facebook groups with 5,000+ members, live events, business retreats and mastermind weekends with nearly 500 consulting clients as members. He’s helped 1,000s of passionate physical therapists create successful PT businesses all earning 6 and multiple 6 figures.

1. Understand the cash-based model

The first step in transitioning to a cash-based practice is to clearly understand what it involves. 

In a cash-based model, you do not depend on insurance companies for reimbursement of services. Instead, you set your own prices and collect payments directly from patients. While this may sound like a big leap, it can be highly rewarding once you become familiar with the fundamentals.

For pelvic practitioners, a cash-based model is especially attractive because pelvic health services typically necessitate longer treatment sessions. Additionally, insurance reimbursement rates for this specialized care can be low and unpredictable. By adopting a cash-based practice, you can set fees that reflect the value of your time and expertise. This often leads to greater satisfaction for both you and your patients.

After the patient pays for their session, you can provide them with a superbill. A superbill is actually not a bill but rather a detailed receipt that outlines each patient encounter and itemizes the services you provided. Patients can submit this superbill to their insurance for reimbursement.

You can easily generate superbills using Embodia, allowing patients to access, print, and save them anytime from the secure, branded patient portal. Embodia automates much of the superbill administration through the use of defaults and templates. 

2. Build a strong foundation for your practice

Before diving in, you’ll want to establish a solid foundation for your cash-based pelvic practice; this includes:

• Business Structure: Choose the legal structure for your practice (e.g., sole proprietorship, LLC, etc.). Consulting with a lawyer and an accountant can help you ensure you set up your business correctly, safeguarding both your personal assets and your practice.

• Licensing and Insurance: Make sure you are fully licensed to practice in your state. Even though operating a cash-based business means you are not dealing directly with insurance companies, it is still important to comply with state laws concerning licensing and patient care. Additionally, obtaining professional liability insurance is essential.

• Location and Facility: Choose a location that is easily accessible to your target population. For pelvic health, you should consider privacy and comfort, as patients may have concerns about discussing sensitive topics related to pelvic health. You may also want to consider offering virtual services.

3. Set your pricing structure

One of the most important decisions you’ll make when going cash-based is determining how much to charge for your services. Since you're not relying on insurance companies, you have the flexibility to set your own rates. However, it’s essential to price your services competitively while also ensuring that the rates reflect the value you provide.

For pelvic practitioners, treatment sessions often require more time and personalized care compared to other practice types. Here are a few tips to consider:

• Assess the Market: Look at what other pelvic practitioners in your area are charging, but don't hesitate to set a higher price if you provide exceptional care and expertise.

• Hourly or Package Pricing: Many cash-based practices offer discounts for package deals,  incentivizing patients to commit to a series of sessions upfront. Alternatively, you could charge an hourly rate for each session. If you’re using Embodia’s practice management system, you can set up packages and memberships, to offer your clients.

• Consider Sliding Scale: While many cash-based practices have a fixed rate, some offer sliding scale pricing to patients experiencing financial difficulties, ensuring they have access to quality care.

4. Hone Your Message & Own Your Niche

Helping your ideal clients find you is crucial for a successful cash-based practice, here are some things to consider: 

• Hone your Message.  You likely didn’t get into pelvic floor therapy because you enjoy marketing. However, mastering the language you use in your marketing is the difference between no one finding your practice and a practice that has a waitlist.  And the first step is to craft what’s known as a unique value proposition (UVP). What’s a UVP? A UVP is simply a direct and clear sentence that explains who you help, the problem you help them with, and the outcome they desire. You can do this by filling in the following sentence “We help (YOUR IDEAL CLIENT) with (THE PROBLEM THEY HAVE) so they can (THEIR DESIRED OUTCOME).” To make this concrete, here are two examples depending upon the population you are serving. “We help athletes with core and pelvic floor weakness so they can perform at their highest level without injury” and “We help new moms with postpartum recovery so they can regain strength, confidence, and control over their bodies.”  Honing your message allows your ideal clients to immediately understand that you are the solution to their problem. -Doug Vestal 

• Own Your Niche. Stop trying to be everything to everyone. The key to a successful cash-based practice is being crystal clear about who you serve and what specific problem you solve. Are you the go-to therapist for runners with knee pain? Do you help CrossFit athletes avoid injuries? The more specific you are, the easier it is for people to refer patients to you. -Dr. Aaron LeBauer

5. Market your practice

After setting up your practice, it's essential to market it effectively to attract new patients. Since your practice operates on a cash-based model, your marketing efforts should emphasize the value of your services and your specialization in pelvic health.

Using a multi-pronged marketing strategy is key. If your entire marketing plan is just posting on Instagram, you’re leaving money on the table. You need a mix of strategies: social media, a website that converts visitors into patients, email marketing, in-person events, and word-of-mouth referrals. And yes, sometimes even paid ads—if they’re done right. -Dr. Aaron LeBauer

Here is a bit more information on these and other strategies to get you started:

• Build an Online Presence: Create a professional website that details your services, highlights your expertise in pelvic health, and enables potential patients to schedule appointments online. Include testimonials and success stories from your patients to foster trust. You can add your unique Embodia online booking link to your website, email or social media marketing campaigns, enabling patients to book appointments online. The booking requests feature allows patients to submit a request for an appointment, which helps reduce drop-offs.

• Content Marketing: Consider starting a blog or creating videos focused on pelvic health topics, such as incontinence, pelvic pain, postpartum care, or prolapse. These resources can address common concerns your patients may have. Additionally, by writing SEO-optimized blog posts, you can attract traffic to your site from individuals searching for solutions to their pelvic health issues.

• Social Media: Platforms like Instagram, Facebook, and YouTube are powerful tools for connecting with patients, particularly in niche areas such as pelvic health. Share educational content, patient testimonials, and your personal experience as a pelvic practitioner.

• Referral Networks: Doug and Aaron clearly agree on this one, relationships are key! 

Relationships, relationships, relationships.  There is an adage in real estate that it is all about location, location, location.  And in a cash-pay practice it is all about relationships. The most successful practice owners spend a large part of their time (especially in the beginning) building relationships. They build relationships with other healthcare providers who are seeing their ideal clients. They build relationships with allied businesses interacting with their ideal clients (e.g., prenatal yoga studios, fitness instructors, etc.).  And they spend a lot of time building relationships in their community through community events and workshops. There are people in your community currently seeing your ideal client and building relationships with them will result in more and more referrals to your cash-pay practice. -Doug Vestal

Build Relationships, Not Just a Business. Most clinicians think marketing is all about ads and social media, but real success comes from relationships. Connect with local gym owners, trainers, chiropractors, and businesses that serve your ideal clients. Offer workshops, free assessments, or team up for events. The more people know, like, and trust you, the more referrals you’ll get. -Dr. Aaron LeBauer

6. Manage your finances and operations

Running a cash-based practice means you are responsible for overseeing all aspects of the business, including finances. Here’s what you’ll need to keep track of:

• Billing and Payments: Choose a straightforward system for managing payments, whether through credit card processing, invoicing software, or payment plans. Communicate your payment policies to patients upfront clearly. Embodia’s practice management software lets you easily process and track payments in just a few clicks, sell packages, memberships and gift certificates and even allow for partial or complete payment for online bookings.

• Taxes and Accounting: Keep track of your income and expenses, and work with an accountant to better understand your tax obligations. Depending on your income, you may be required to file quarterly estimated taxes.

• Time Management: Managing your own schedule is one of the benefits of a cash-based practice, but it’s also important to balance patient care with business management tasks. Use scheduling software to manage appointments and reduce administrative work. Embodia’s scheduling features provide a secure and user-friendly calendar interface, allow hassle-free online patient booking with a waitlist option, send automated appointment reminders, sync with external calendars like Google, and offer comprehensive appointment reporting to monitor trends and no-shows.
  
  

7. Grow Mental Resilience 

Your outer results will be directly influenced by your inner work. Here’s how resilience can help you find success in your cash-based ventures:  

• Growing a cash-based pelvic floor practice requires mental resilience. Many practice owners I mentor struggle with confidence, imposter syndrome, and fear of rejection. This is normal. But as one of my students put it, “I realized I can be scared but do it anyway.” Success comes from taking action before you feel ready. Write the post. Introduce yourself to that provider. Host the workshop. Confidence doesn’t come first—action does. Reframe your mindset around the core activities that will grow your practice: marketing isn’t selling—it’s educating. Networking isn’t bothering people—it’s building relationships. Not everyone will be your client, and that’s okay. The people who need you won’t find you unless you put yourself out there. Believe in your value. Take the next step. Scared or not, do it anyway. Your future practice—and the people who need you—depend on it. -Doug Vestal

Success in cash-based practice isn’t about waiting for patients to find you—it’s about positioning yourself as the best option, building trust, and taking control of your business. -Dr. Aaron LeBauer

While transitioning to a cash-based pelvic practice takes planning, effort, and patience, the rewards can be immense. By following the steps outlined in this guide, you can create a thriving practice that provides patients with the best possible care while allowing you to maintain a sustainable and fulfilling career.

If you're ready to enter the cash-based world, now is the perfect time to begin!

Resources

Here are some additional resources to help you build a successful cash-based practice:

1. Doug Vestal’s book: Financial Freedom for OTs: A Guide to Building Wealth Without Burnout 
2. Doug Vestal’s website: Freedom of Practice
3. If you’re ready to go all in and transition to a cash practice, grab a free copy of Aaron LeBauer’s The CashPT® Checklist 
4. Podcast: Aaron LeBauer Show
5. A Beginner's Guide to Superbills & Receipts for a Cash Practice∙ 
6. A Superbill Glossary for Physical Therapists: Your Go-To Cheat-Sheet for Your Cash-Based Practice
7. Pelvicon

More information about the Embodia features mentioned in this blog:

Scheduling on Embodia 

1. Video tutorial: Online booking experience
2. Introduction to online booking
3. Using the calendar view
4. Video tutorial: Waitlist management
5. Booking request forms
6. Video tutorial: Consult settings (includes sending automated appointment reminders)
7. Connecting to Google Calendar

Reports on Embodia

8. Statistics and Reports

General billing on Embodia 

9. Introduction to packages and memberships
10. Gift certificates
11. Billing: Managing a patient invoice
12. Billing: Accepting credit card payment
13. Invoice status tracking

Superbills on Embodia

14. Introduction to superbills

15. Video tutorial: Superbills (below):

Superbills video tutorial:

Embodia practice management user testimonial

Book my free demo with Embodia

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Date written: 28 Feb 2025
Last update: 4 Mar 2025