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  • Writer's pictureNicole Cozean

Pros and Cons of a Cash-Based Practice

We're taking an honest look at the pros and cons of working in a cash practice.

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Pelvic PT Rising: The pelvic health tools to make you a better clinician and/or a more successful business owner. We want every single pelvic health practitioner to be more confident and successful in your practice and career!

  • Clinical Courses: Game-changing online courses to make you more confident, challenge your thinking and improve patient outcomes

  • Business Resources: Helping 500+ pelvic health practitioners confidently start, grow and build their dream business!


As most of you know, PelvicSanity is a cash practice and we've been working without interacting with insurance companies for more than 7 years.

But that might not be the right decision for everyone. So we want to lay out the pros and cons. Whether you're a 'wannabe' considering your options or an already established business wanting to make sure you got it right, this should help!

Clinical - Cash

Cash practice gets insurance completely out of the picture. Hour-long (or two-hour) treatment sessions, wellness, working with patients for a longer plan of care - as long as you and the patient believe it's worthwhile, you can do what you clinically believe!

Financial - Cash

In terms of profit margin and the financial metrics, a cash practice wins. You have control over your profit margin, instead of insurance capping reimbursement. There are no cash flow issues.

Marketing & Sales - Insurance

This is always the biggest challenge for cash-based practices. Being 'in network' literally means you're part of a referral network. You might still have to do some work, but you should have a much easier time in an insurance practice of getting patients to call and schedule. Your ability to do this in a cash practice is vital for success.

Ability to Grow - Tie

Both types of practices can grow, and have different issues. An insurance-based practice often has the patient volume to grow, but with low profit margins it can be difficult to hire and expand while still paying yourself. A cash practice can expand with good profit margins, but the marketing and sales need to be on point.

Lifestyle - Cash

With a cash practice you can work fewer hours. You don't have insurance BS. You don't have a biller. And you can treat how you want.

Learn more about pelvic health with our Clinical Courses

All of the Rising clinical courses are designed to:

  • Challenge the way you think

  • Make you more confident in your clinical practice.  

  • Allow you to go-at-your-own pace (all online!)

  • Let you go back to your work: you'll have lifetime access to the lectures and handouts.  Check out all the clinical courses we offer (

Curious about private practice? Check out our Business Resources

  • We've now helped more than 200 cash-based pelvic health practices start and grow.  

  • We want to make sure you're building a business that works for you (instead of vice-versa) and actually enjoy the process along the way!  

  • See all the business resources we offer (, tailored specifically to pelvic health!


Nicole Cozean, PT, DPT, WCS

Founder of Pelvic PT Rising and PelvicSanity Physical Therapy in Southern California.

Dedicated to forever changing pelvic health with online clinical courses to help you be more confident in your practice and business resources to help start and grow pelvic health businesses.

Jesse Cozean, MBA

Co-founder of the Pelvic PT Rising and the Rising Podcast.

Jesse uses his business experience to help pelvic health business owners start and grow their practices so they can build a practice that truly works for them. From website design, SEO, conversions, marketing, finance and money mindset, he wants to make the process of owning your own practice easier and fun.

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