How Payment Works at Lymph-A-Hand

Lymph-A-Hand is a primarily cash-based practice. This allows us to provide focused, individualized care without the time restrictions and treatment limitations often imposed by insurance plans.

By choosing our cash-based services, you receive:

• Extended one-on-one sessions
• Personalized, holistic treatment plans
• Flexibility in care that is guided by your needs—not insurance authorizations

Insurance Participation

While we are primarily cash-based, we do participate with:

• Medicare Part B
• Select Workers’ Compensation plans

If you have a Workers’ Compensation claim, coverage depends on your employer’s carrier and authorization approval. Please contact us prior to scheduling so we can verify eligibility.

For all other insurance plans, we are considered out-of-network. We are happy to provide a detailed superbill (receipt) that you may submit to your insurance provider for possible reimbursement.

We also accept HSA and FSA payments.

Your healing should be guided by clinical expertise—not insurance codes—and we are here to support your journey with transparency and clarity every step of the way.

How is care structured at Lymph-A-Hand?

At Lymph-A-Hand, healing is never rushed. We offer two thoughtfully designed pathways to care, depending on your coverage and personal goals.

Insurance-Based Outpatient Rehabilitation (In-Office)

For clients covered under:

• Medicare Part B

• Authorized Workers’ Compensation (ION Network)

These services are provided in-office and billed according to medical necessity and authorization guidelines. Each session remains one-on-one and personalized, even within insurance structure.

Concierge Rehabilitation & Wellness (Direct-Pay)

Our Concierge model offers a more flexible and restorative experience. Services may be delivered in-office or in the comfort of your home and are direct-pay.

Concierge care is ideal for:

• Extended one-on-one orthopedic rehabilitation

• Post-surgical recovery for the hand, wrist, elbow, or shoulder

• Chronic upper extremity pain or stiffness

• Specialized lymphatic drainage and swelling management

• Scar mobilization and soft tissue restoration

• Wellness, maintenance, and preventative care

• Clients with commercial insurance plans we are out-of-network with

• Home-based recovery and convenience-focused care

This pathway allows for deeper clinical attention, hands-on treatment, and a calming therapeutic environment tailored to both structural and lymphatic healing.

If you are a Medicare beneficiary and services qualify as medically necessary outpatient therapy covered under Medicare Part B, we are required to bill Medicare.

Concierge services are available for:

• Wellness or maintenance care

• Preventative or convenience-based sessions

• Services not covered under Medicare guidelines

• Home-based services outside Medicare’s outpatient structure

Can I receive therapy in my home if I have Medicare?

Medicare-covered outpatient therapy services are provided in-office under federal guidelines.

Home-based services are available exclusively through our Concierge Care model as a direct-pay option and may include wellness, maintenance, or services not covered by Medicare.

If you require Medicare-certified home health services, we are happy to help guide you toward appropriate resources.

Concierge Care at Lymph-A-Hand is our elevated, one-on-one service model designed to provide a more personalized and restorative rehabilitation experience.

This includes:

• Extended session time for both treatment and discussion

• Comprehensive, hands-on orthopedic and lymphatic care

• Personalized treatment planning tailored to your goals

• Flexible scheduling

• Optional in-home visits

• A private, calming environment that supports focused healing

All clients — including those choosing Concierge Care — must have an appropriate physician order prior to beginning therapy services.

Concierge Care allows for deeper clinical attention, thoughtful conversation, and individualized care beyond the structural limitations of insurance-based services.

Insurance-based services are billed according to medical necessity and authorization requirements.

Concierge services are direct-pay, and payment is collected at the time of service. Detailed receipts are provided for your records and potential out-of-network reimbursement when applicable.

Yes. Lymph-A-Hand requires a referral from your physician prior to beginning therapy services.

This ensures coordinated care and allows us to provide the most informed, personalized treatment possible.

If you need assistance obtaining a referral, we are happy to help guide you through the process.

Whether you are seen in our Mobile clinic or through concierge care in your home, each session is thoughtfully prepared to meet your specific needs.

In-office visits are conducted in a calm, private setting designed to support focused, one-on-one treatment. All necessary equipment and materials are prepared in advance, so your time is used intentionally and efficiently.

For concierge appointments, we bring therapy directly to you. We arrive approximately 15 minutes before your scheduled session to allow time for setup, which may include a portable treatment table, clean linens, and specialized equipment tailored to your condition — such as supplies for lymphatic therapy, post-surgical recovery, or upper extremity rehabilitation.

Creating a safe, comfortable, and effective healing environment — whether in our clinic or in your home — is an essential part of the care we provide. Our goal is to ensure you feel supported, respected, and fully focused on your recovery.

nitial evaluations typically last 60 to 90 minutes, depending on your condition and the complexity of care.

Follow-up sessions are usually 60 minutes, but may extend to 90 minutes if you're receiving lymphatic therapy, post-oncologic rehab, or need more intensive hands-on support. As your recovery progresses, session length may be adjusted to best meet your evolving needs.

If you’re recovering from surgery, undergoing chemotherapy, or experiencing fatigue, I work closely with your medical team to ensure therapy is appropriate, safe, and aligned with your current capacity. In some cases, 30 minutes may be the most your body can tolerate—and that’s okay. We honor where you are, and build from there.

Every session is individually tailored to support your healing process, goals, and overall well-being.

Hand therapy is a specialized form of rehabilitation focused on restoring function, strength, and mobility in the hand, wrist, elbow, and shoulder—also known as the upper extremity.

It’s provided by an occupational or physical therapist with advanced training in treating conditions such as:

• Post-surgical recovery (fractures, tendon repairs, nerve injuries, etc.)

• Arthritis or joint pain

• Carpal tunnel syndrome or nerve compression

• Tendonitis and overuse injuries

• Scar management and swelling

• Stiffness, weakness, or loss of fine motor skills

As a Certified Hand Therapist (CHT), I use a combination of manual therapy, customized exercise programs, orthotic (splint) design, and pain management techniques to help you return to the activities you love—whether that’s buttoning a shirt, swinging a golf club, or writing comfortably.

What is a Certified Hand Therapist (CHT)?
A Certified Hand Therapist (CHT) is a licensed occupational or physical therapist who has advanced training and experience in treating conditions of the upper limb—shoulder, arm, elbow, wrist, and hand.

To become a CHT, a therapist must have:

• At least three years of clinical experience

• Over 4,000 hours of direct hand therapy practice

• Passed a rigorous national exam that tests advanced skills and knowledge in upper limb rehabilitation

CHTs are dedicated professionals who go above and beyond to stay current with the latest techniques and research. They must continue learning and regularly recertify to maintain their credentials and provide the highest standard of care.

What is a Certified Post-Surgical Therapist?

A Certified Post-Surgical Therapist is a licensed rehabilitation professional—such as an occupational or physical therapist—who has received specialized training in how to safely and effectively support healing after surgery.

This expertise goes beyond general rehab. A certified post-surgical therapist understands how different surgical procedures—like breast cancer surgery, orthopedic repairs, or cosmetic surgeries—affect the body’s systems, including the lymphatic, muscular, fascial, and nervous systems.

At Lymph-A-Hand, our post-surgical therapist holds advanced training in:

• Lymphatic drainage therapy to reduce swelling and prevent complications like lymphedema

• Scar and myofascial tissue release for mobility and pain relief

• Oncology rehabilitation to support breast cancer recovery

• Orthopedic recovery for strength and functional return after injury or repair

We also collaborate with your surgical team to ensure the care you receive complements your procedure—never disrupts it. It’s about healing the right way, with the right hands.

At Lymph-A-Hand, we support clients with a range of chronic conditions related to the upper extremities and lymphatic system, including:

• Hand and wrist arthritis
• Post-surgical stiffness or weakness
• Repetitive strain injuries (such as carpal tunnel or De Quervain’s)
• Ongoing orthopedic pain
• Soft tissue and scar-related discomfort
• Upper extremity lymphedema, including breast cancer–related and chronic presentations

However, we do not provide ongoing management for chronic or advanced lower extremity lymphedema. This level of care typically requires intensive, high-frequency complete decongestive therapy (CDT) within specialized lymphedema or vascular programs, which is not offered within the current model of this practice.

We focus on early-stage lower extremity swelling, post-surgical support, prevention, and comprehensive upper extremity care.

If you're experiencing persistent pain, swelling, or functional limitations and don’t see your condition listed, please contact the clinic. We are happy to discuss whether our services are a good fit — or guide you to the appropriate provider if needed.

Q: I had swelling in my legs after surgery. Can you help?
A: Yes! While we primarily focus on upper extremity care, we do treat post-surgical swelling in all areas of the body, including the legs, after procedures like cosmetic surgery or joint replacements.

Q: What don’t you treat?
A: We do not treat chronic lower extremity lymphedema (such as long-standing leg swelling from venous or lymphatic disease) or vascular conditions like venous insufficiency. If that applies to you, we’re happy to recommend a specialist.

Yes — we provide treatment for upper extremity (arm and breast-related) lymphedema at all stages, including more advanced or chronic presentations.

As a Certified Lymphedema Specialist, we support individuals experiencing early signs of lymphedema or post-surgical swelling. Our approach emphasizes prevention, education, and early intervention — particularly during Stage 0 and Stage I, when swelling is often mild and reversible.

Services may include:

• Education on early warning signs
• Manual Lymphatic Drainage (MLD)
• Gentle compression and light bandaging when appropriate
• Scar and soft tissue mobilization
• Self-care strategies to support long-term lymphatic health

For lower extremity swelling, we focus on early-stage, reversible conditions. Ongoing management of advanced or chronic lower extremity lymphedema is not provided within this practice. If a higher level of care is needed, we are happy to assist with referrals to specialized programs.

Lymph-A-Hand is a primarily cash-based, out-of-network wellness practice. While we do not stock or sell bandaging supplies or compression garments, we are happy to apply bandaging or assist with compression during your session — you’ll simply need to bring your own supplies.

If you’re unsure what to purchase, we will:

• Guide you on the appropriate bandaging or compression for your condition
• Recommend trusted local or online vendors (such as medical supply providers or specialty lymphedema retailers)
• Help determine whether your symptoms can be managed within this practice or may require referral for complete decongestive therapy (CDT)

For patients using Medicare or authorized Workers’ Compensation benefits, coverage and supplier requirements may vary. We will help you understand your options.

Our goal is to ensure you feel informed, supported, and confident in managing your care.

Yes—you can and should begin rehabilitation before surgery. Pre-operative (Phase I) rehab helps prepare your body, reduce post-surgical complications, and improve recovery outcomes. This phase focuses on gentle mobility, education, and lymphatic preparation—nothing that would interfere with your surgical site, drains, or healing.

Post-surgery, we tailor therapy to your stage of healing. Early rehab focuses on gentle, safe movement and scar management to prevent stiffness and swelling. We are highly experienced in working around drains and surgical restrictions with care and precision.

Yes, you can continue receiving therapy during radiation. In fact, it often helps reduce fatigue, manage skin sensitivity, and maintain range of motion.

As for YouTube—while online videos might offer general exercises, they can’t assess your unique surgical history, lymphatic needs, or restrictions. We specialize in individualized, medically informed care that’s safe, empowering, and designed just for you. Your body—and your recovery deserve more than a one-size-fits-all video

Manual Lymphatic Drainage isn’t just for one type of person — it’s for anyone who wants to support their body’s natural healing and detox processes, especially during times of recovery, stress, or transition.

MLD is especially helpful for:

Post-surgical clients – including mastectomy, cosmetic procedures (like liposuction or tummy tuck), orthopedic surgery, or joint replacements — to reduce swelling, bruising, and promote smoother healing.

Individuals currently in or recovering from cancer treatment – with physician clearance, MLD offers safe, gentle support for swelling, discomfort, and emotional stress.

Pregnant individuals – particularly in the second and third trimesters, MLD can ease fluid retention, reduce swelling in the legs and feet, and support circulation. (Always performed with medical approval.)

Those with lymphedema or chronic swelling – to manage fluid buildup, ease discomfort, and maintain mobility.

People recovering from injury or trauma – MLD supports tissue repair and calms inflammation.

Anyone feeling puffy, sluggish, or inflamed – MLD promotes gentle detoxification and helps reset the body’s natural rhythm.

Those experiencing chronic stress or fatigue – the calming, rhythmic nature of MLD promotes deep

When Oncology Massage & MLD May Not Be Appropriate

If you have active blood clots (DVT)
If you are in active infection or fever
If you have low blood counts or fragile skin from radiation
If there is cancer-related swelling without a clear diagnosis
If you are undergoing specific types of treatment that require temporary delay of massage

We always work in collaboration with your medical team, and your comfort and safety come first.

Whether you're recovering from oncologic surgery, orthopedic injury, or preparing for an active return to life, our sessions are designed to go far beyond simple movements. We focus on dynamic, functional rehabilitation tailored to your goals—whether that’s reaching into cabinets, returning to yoga, swinging a golf club, or rock climbing again.

Please wear comfortable, loose-fitting or activewear-style clothing that allows full access to the area we’ll be treating and freedom of movement.

• For manual lymphatic drainage, non-restrictive, breathable clothing is essential.

• For upper extremity and hand therapy, everyday activewear is usually appropriate.

• If a session involves postural retraining, strength work, or more athletic movement, I’ll notify you in advance so you can dress accordingly.

Your therapy is not one-size-fits-all. It’s intentional, hands-on, and results-focused—designed to help you move, live, and thrive again.

If treatment is related to an authorized Workers’ Compensation injury, services must be billed to the approved claim and follow authorization guidelines.

Concierge services may be available for:

• Care unrelated to the work injury

• Services outside the authorized claim

• Wellness or maintenance support