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: 5 minutes

Becoming a cash-based (pelvic) health practitioner

The healthcare industry is rapidly evolving, leading many practitioners to successfully transition to cash-based practices, where patients pay directly for services without insurance involvement.

This model offers greater control over practice, schedule, and income, particularly in pelvic health, where demand for pelvic floor therapy is growing.

If you’re a healthcare practitioner considering this shift, this guide will outline the essential steps, challenges, and rewards of moving to a cash-based practice, along with features from Embodia that can support your success

1. Understand the cash-based model

The first step in transitioning to a cash-based practice is to understand its essentials. In this model, you set your own prices and collect payments directly from patients, eliminating reliance on insurance reimbursement.

For pelvic practitioners, this approach is appealing due to longer treatment sessions and often low, unpredictable insurance rates.

A cash-based model allows you to set fees that better reflect your expertise, enhancing satisfaction for both you and your patients.

After a session, you can provide a superbill, a detailed receipt outlining services provided, which patients can submit to their insurance.

Superbills can be generated with Embodia (check out the resource video at the end of the blog to learn more).

2. Build a strong foundation for your practice

Before starting your cash-based practice, establish a solid foundation by considering the following:

1. Business Structure: Select a legal structure (e.g., sole proprietorship, LLC) and consult a lawyer and accountant to protect assets and ensure proper setup.
   
   
2. Licensing & Insurance: Ensure you are fully licensed in your state and comply with patient care laws. Obtain professional liability insurance.
   
   
3. Location & Facility: Choose a location easily accessible to your target population. For pelvic health, choose one that prioritizes privacy and comfort for discussing sensitive issues. Consider also offering virtual services.
   
   
   

3. Set your pricing structure

One of the key decisions in transitioning to a cash-based model is setting your service rates.

Without relying on insurance, you can determine your own prices, but it’s important to remain competitive and reflect the value you provide.

For pelvic practitioners, treatment sessions typically require more time and personalized care. Here are some tips:

• Assess the Market: Research what other pelvic practitioners charge, but feel free to set higher rates if your care and expertise are exceptional.
  
  
• Hourly or Package Pricing: Consider offering package deals for discounted rates, encouraging patients to commit to multiple sessions, or charging an hourly rate. If using Embodia, you can set up packages and memberships for your clients.
  
  
• Consider Sliding Scale: While many cash-based practices maintain a fixed rate, some offer sliding scale pricing for patients facing financial challenges, ensuring 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).
  
  

  
  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.” -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 establishing your practice, effective marketing is crucial to attract new patients.

Emphasize the value of your services and your specialization in pelvic health, using a multi-pronged marketing strategy.

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. The booking requests feature allows patients to submit a request for an appointment, helping reduce drop-offs.

• Content Marketing: Consider starting a blog or creating videos focused on pelvic health topics, addressing 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 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 experience as a pelvic practitioner.

• Referral Networks: Doug and Aaron agree on this one; relationships are key ↓

6. Manage your finances and operations

Running a cash-based practice means overseeing all business aspects, including finances. Here’s what to track:

1. Billing and Payments: Use a simple system for managing payments, such as credit card processing or invoicing software. Clearly communicate payment policies to patients. Embodia’s practice management software allows you to process payments, sell packages, and enable partial or complete online booking payments easily.
   
   
2. Taxes and Accounting: Keep records of income and expenses, and consult an accountant to understand your tax obligations. You may need to file quarterly estimated taxes based on your income.
   
   
3. Time Management: While managing your own schedule is a perk, balancing patient care with business tasks is vital. Use scheduling software to streamline appointments. Embodia offers a user-friendly calendar, online booking with a waitlist, automated reminders, and comprehensive appointment reporting to track trends and no-shows.

7. Grow mental resilience 

Your outer results will be directly influenced by your inner work. Growing a cash-based pelvic floor practice requires mental resilience.

 Here’s how resilience can help you find success in your cash-based ventures:  


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

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

More information about the Embodia features mentioned in this blog:

Superbills on Embodia

• Introduction to superbills

• Video tutorial: Superbills (below):
  
  

Scheduling on Embodia 

• Video tutorial: Online booking experience
• Introduction to online booking
• Using the calendar view
• Video tutorial: Waitlist management
• Booking request forms
• Video tutorial: Consult settings (includes sending automated appointment reminders)
• Connecting to Google Calendar

Reports on Embodia

• Statistics and Reports

General billing on Embodia 

• Introduction to packages and memberships
• Gift certificates
• Billing: Managing a patient invoice
• Billing: Accepting credit card payment
• Invoice status tracking
  
  

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

• Doug Vestal’s book: Financial Freedom for OTs: A Guide to Building Wealth Without Burnout 
• Doug Vestal’s website: Freedom of Practice
• 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 
• Podcast: Aaron LeBauer Show
• A Beginner's Guide to Superbills & Receipts for a Cash Practice∙ 
• A Superbill Glossary for Physical Therapists: Your Go-To Cheat-Sheet for Your Cash-Based Practice
• Pelvicon

Book my free demo with Embodia

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Date written: 28 Feb 2025
Last update: 10 Jul 2025