Please review the following information carefully prior to coming in for your visit.
At the bottom of the page are 2 links labeled ‘consent to treat’ and ‘patient intake’ if you are able to fill them out prior to the evaluation it will allow for more time to be spent performing the assessment/treatment.
Your typed signature on the ‘consent to treat’ form acknowledges that you have read and agree to the following information:
-The first session is an evaluation session which will include treatment (55 minute session).
-At the end of the first visit, we will discuss if this treatment approach will be appropriate for you and if you may need additional visits. Follow up visits will be scheduled with both Mary and Rusty to allow for better access for appointments. You will find great continuity of treatment between the 2 therapists as both have had extensive manual therapy training and have worked together as a team for over 10 years.
-A typical follow-up session will last 50-55 minutes including manual/hands-on work and exercise as appropriate.
-Please wear loose fitting clothing.
-Do not eat one hour prior to your treatment.
-Let me know if you are receiving additional therapy from other practitioners or body workers, as it may or may not conflict with treatment.
- Motus Physical Therapy is a self-pay practice.
-We DO NOT bill insurance companies, including Medicare.
If you are Medicare patient (PLEASE READ), you can “refuse, of his/her own free will, to authorize the submission of a bill to Medicare” (section 40, chapter 15 of the Medicare Benefit Policy Manual). If this is the case for you, I will ask you to sign an agreement (included in the Consent to Treat form below) that states neither you nor I will send claims by Motus Physical Therapy, LLC to any 3rd party payor (Medicare and all secondary insurances) and you will not allow anyone else to send claims on your behalf.
(In short, the above paragraph says that you will NOT attempt to get reimbursement for your treatment session at Motus Physical Therapy from Medicare.)
Mary-
PT Evaluation (1st visit)— $145 (tax included) PT Follow-up visit— $135 (tax included)
Rusty-
PTA Follow- up visit— $110 (tax included)
^^^ If your treatment is associated with a motor vehicle accident involving legal action (litigation) or insurance involvement please let us know at the first visit. An additional $25 fee will be added to each visit for additional documentation time required^^^
- Cash, check and major credit/debit cards* and contactless EMV chip cards* or Apple/Android pay*. *A 2.75% convenience fee will be added to all credit/debit card transactions.
- We accept FSA and HSA card payments.
-Late Cancellation Fee: $50.00 - late cancellation fee for less than 24-hours notice because when you make an appointment, we reserve this time for you. If you need to cancel your appointment, please give us 24-hours notice, so we can have time to schedule someone else.
The exceptions to the 24 business hours rule are:
1. Sickness— please do not come in if you are not feeling well or have a fever or cough
2. Snow/ice— your safety is most important to us
-No Show Policy: If you do not contact us, you will be charged the full fee for the session. If you have 2 no-shows in 6 months, your treatment will be terminated.
The address is 7814B Pan American Fwy, Abq, NM 87109. We are located in the North Gate complex off of Northbound Pan American just past Pino Street and before Ashley furniture. The building is at the end of the round-about and we are on the North side of the building, there is designated parking on the north side of the building too.