One hour. One clinician. No shortcuts.
Why Physica Medica Is Out-of-Network
Insurance reimbursement is built around a specific model: short sessions, high patient volume, delegated care. That model has its place. It is not this place.
To bill insurance at a rate that keeps a practice financially viable, a clinic needs to see multiple patients per hour, limit hands-on time to roughly 15 minutes, and rely on aides or techs for the remainder of the session. The math is straightforward. There is no version of that model that allows Dr. Birikov to spend a full hour, every session, doing manual therapy on one patient.
Physica Medica operates outside that system entirely. Every session is one hour. Every session is one-on-one with Dr. Birikov. There are no techs, no aides, no handoffs. The concierge model exists because the work requires it, not as a marketing position.
WHAT YOU GET
**What a Session at Physica Medica Actually Includes**
When you book at Physica Medica, you get Dr. Birikov's full attention for the entire session. Not a brief assessment followed by supervised stretching. Not a treatment plan handed off to someone else. One clinician, one patient, one hour of hands-on manual therapy.
Dr. Birikov holds a Doctor of Physical Therapy degree and carries credentials that do not exist elsewhere in Baltimore. He is the first and only master-certified dry needling practitioner in the city, a designation that reflects advanced clinical training beyond the standard PT licensure requirement. He is also the only Functional Patterns practitioner in Baltimore, trained in a system that traces movement dysfunction to its structural origins rather than treating symptoms in isolation. His manual therapy training includes European fascial therapy methods that are not part of standard American PT curricula.
Before your first session, Dr. Birikov personally reviews your intake information. He arrives knowing your history. The session begins with assessment, not paperwork.
This is the difference between a generalist seeing 20 patients a day and a specialist who has structured his entire practice around the kind of case that hasn't responded to anything else.
INSURANCE REIMBURSEMENT
**Out-of-Network Reimbursement, HSA, and FSA**
Physica Medica does not bill insurance directly. After each session, you will receive a superbill, a detailed receipt that includes the diagnostic and procedure codes your insurer needs to process an out-of-network claim. You submit that document to your insurance company directly.
Whether you receive reimbursement, and how much, depends on your specific plan. Plans with out-of-network benefits will often cover a portion of the cost once your out-of-network deductible is met. The steps are straightforward:
- Contact your insurer before your first session and ask about your out-of-network physical therapy benefits. - Ask specifically about your out-of-network deductible and reimbursement percentage. - Submit the superbill Physica Medica provides after each session. - Your insurer processes the claim and reimburses you directly.
If you have a Health Savings Account or Flexible Spending Account, physical therapy services are an eligible expense. HSA and FSA funds can be applied to your sessions without restriction.
[Session rates are discussed directly with Dr. Birikov prior to or at your initial consultation.]
VALUE COMPARISON
**The Real Cost of the Other Model**
Consider what the standard insurance-based PT experience typically looks like: an initial evaluation, then a series of 45-minute appointments where 15 to 20 minutes is hands-on time and the rest is supervised exercise. The clinician rotates between three or four patients in the same hour. Progress is measured in months. Many patients complete a full course of treatment and return to their doctor reporting that PT didn't work.
That's not a criticism of the clinicians inside that system. It's a description of what the system allows.
The question worth asking is not whether Physica Medica costs more per session than a co-pay. The question is what the total cost of the problem has been: the appointments that didn't resolve it, the time off work, the things you've stopped doing because of pain. A focused course of treatment that identifies the actual source of the problem and addresses it directly is a different calculation.
Most patients at Physica Medica are not first-time PT patients. They've already tried the standard model. They're here because it didn't hold.
Ready to Start?
If you have questions about pricing, out-of-network benefits, or whether your situation is a good fit for this kind of care, send a message through the contact page. Dr. Birikov reads every inquiry personally and responds directly.