The key to growth is stepping outside of your comfort zone. This is one of the best pieces of advice I’ve ever received, and I can personally attest to its validity. Whether it was trekking solo across a foreign country where I didn’t speak the language or trying a totally new sport (side note: roller derby is no joke!), I’ve made it a point to put myself in unfamiliar situations. Through these experiences, I’ve learned that branching out and experimenting with new activities has a lot of value—and the same can be said for physical therapists who deviate from their typical service offerings and try something new.

There are plenty of reasons for physical therapists to venture into nontraditional service territory, but the main ones are:

  • You can increase your cash flow by offering services patients can pay for out of pocket.
  • You can become the go-to PT for a particular service if you’re the only provider in town who offers it.
  • You can attract business from new patients who may not have considered PT otherwise.
  • You can market to a whole new audience who may need a PT in the future.
  • You can increase your practice’s online visibility to potential patients who search for these services online.

Clearly, there’s a lot to be said for expanding your service horizons. So, if you’re ready to get more patients into your practice, here are four services to consider offering:

Dry Needling

Dry needling (a.k.a. “trigger point dry needling” or “intramuscular manual therapy”) is a hot topic in physical therapy. You’ve probably heard all about dry needling by now, but if not, here’s a refresher: according to the Mayo Clinic, “Dry needling is a treatment performed by skilled, trained physical therapists, certified in the procedure. A thin monofilament needle penetrates the skin and treats underlying muscular trigger points for the management of neuromusculoskeletal pain and movement impairments.”

Dry needling and acupuncture are not one and the same.

To those unfamiliar with the practice, dry needling sounds a lot like acupuncture. However, whereas acupuncture is rooted in Eastern medicine, dry needling is based on Western medicine. Dry needling targets muscle tissue with the goal of reducing pain, deactivating trigger points, and restoring function. PTs typically use it to supplement traditional physical therapy interventions.

Some payers won’t reimburse physical therapists for dry needling.

While the inclusion of dry needling within the physical therapy scope of practice has been hotly debated, many PT practices—such as Viverant in Minnesota—support the use of this procedure in PT plans of care. That’s because evidence supporting the benefits of this practice in the treatment of chronic pain is pretty substantial. Still, some insurance payers are—unsurprisingly—slow to recognize this, meaning they may not reimburse for it. But, demand for dry needling is increasing. Many patients swear by it and are willing to pay out of pocket for it, which makes it a perfect cash-based service to add to your practice.

Ready to boost your practice’s revenue with cash-based services?

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Fitness Classes

Physical therapists understand the correlation of healthy physical function to overall quality of life. But improving mobility after an injury isn’t the only way PTs impact patient health. Keeping the body in shape is the best way to prevent injury from happening in the first place, which means PT clinics are the perfect venue for people to get in their daily workout.

Personal Training

There’s no one better suited to lead movement-based exercise than a musculoskeletal expert—that is, a physical therapist. While many fitness enthusiasts find the undivided attention and tailored exercise programs offered by personal trainers to be quite appealing, the average trainer can’t match the level of education, physiological knowledge, and experience of a licensed PT—and that makes your fitness and wellness services much more valuable. According to this Wall Street Journal article, physical therapists can charge more than $100 an hour for this kind of service, although that amount may fluctuate depending on your geographic location. If you need help setting your rates, research the market prices for gym services in your area. 

Group Exercise

That said, not every health-conscious consumer can afford one-on-one fitness training. Fortunately, group-led classes provide a far more wallet-friendly alternative. Examples of such classes include:

  • aerobics,
  • dance (e.g., Zumba),
  • BOSU,
  • core conditioning,
  • Pilates,
  • yoga,
  • Barre,
  • muscle conditioning,
  • step,
  • indoor cycling,
  • kickboxing,
  • sculpting,
  • boot camp, and
  • Tabata.

Physical therapy practices may choose to offer a wide array of class types or zero in on a niche. For example, Viverant offers a custom Pilates program that fuses the rehabilitation aspect of physical therapy with the strength-building benefits of Pilates. (You can learn more about this clinic’s approach here.) And many payers actually cover therapy-based fitness services, which opens up this option to patients who rely more heavily on their insurance to pay for such offerings.

Nutrition Counseling

All that said, physical fitness is only one piece of the health puzzle. What you put into your body is equally crucial to preventing diseases like obesity and type 2 diabetes. As WebPT’s Erica McDermott explains here, “a well-balanced, nutrient-dense, anti-inflammatory, whole-foods diet has the potential to reduce pain, speed injury healing, improve recovery outcomes, and even prevent future injury—all things are that uber-relevant to a physical therapist.”

The APTA agrees. As the association explains here, it is “the role of the physical therapist to screen for and provide information on diet and nutritional issues to patients, clients, and the community within the scope of physical therapist practice.” And because they already help patients with their physical health, PTs are perfectly positioned to assist them with their nutritional health, too—thus taking on a totally holistic approach to disease prevention. Some practices—like ATI Physical Therapy—have already caught on to this connection. ATI actually has a Registered Dietitian Nutritionist (RDN) on its team to help individuals achieve their nutrition goals and develop better eating habits.

Keep in mind, though, that some states may not include nutrition in the physical therapy scope of practice, so it’s vital that you check your state practice act before offering any nutrition services in your clinic.

Telehealth

Telehealth therapy—or “telerehab”—is another frequently discussed topic in the PT realm. We’ve covered telehealth quite a bit on the WebPT Blog (here and here, for example), but to provide a quick summary of the telehealth situation in rehab therapy, many payers have been slow to include physical therapists on their list of approved telehealth service providers—despite patient demand.

Tele rehab increases patient access to quality care.

Sure, at its core, physical therapy is a hands-on treatment discipline. Still, technology such as video conferencing has made it possible for providers to give their patients instant feedback without time-consuming office visits. This is especially helpful for homebound patients who may be unable to travel on their own as well as patients in rural areas who have limited access to a physical therapist in their region. It also opens the door for patients who travel frequently or wish to see a provider out of state. For example, an Arizona-based PT who works with triathletes might charge a flat fee to provide a cash-based teletherapy consult for a patient who lives in Chicago during the summer months. In this case, as long as the therapist is licensed in Illinois, he or she is able to treat these patients and receive cash for those services (thanks in part to the expansion of the physical therapy licensure compact).

You’re still beholden to state and federal laws.

Of course, if you’re in a position to offer telehealth services, it’s vital that you take necessary precautions where HIPAA is concerned. Make sure that whatever video conferencing platform you choose can guarantee security and HIPAA compliance. You should also verify your state’s current legislation regarding telehealth in a PT setting before offering the service in your practice.


Getting out of your comfort zone is never easy, but for physical therapists, it can be a serious boost to your clinic’s cash flow. With a little research—and the right attitude—you can extend your reach to new patients who might not have considered PT before and show them the value of what you do—and that’s certainly wisdom worth sharing.