Payments & Insurance

Pennsylvania Headache Center is a direct-pay specialty practice. Patients pay PHC directly for office visits, in-office procedures, and headache-specific care. We do not bill commercial insurance, Medicare, or Medicaid for these services.

The direct-pay model is intentional. It lets us spend the time each patient actually needs, keep our schedule open enough to see new patients within weeks rather than months, and build treatment plans around the patient in front of us, rather than around what an insurance company will authorize. It is the same model used by a growing number of headache subspecialty practices nationally.

Insurance still plays a role in your care. While your visits with us are direct-pay, we use your insurance for the things insurance handles well – prescription medications, laboratory work, and imaging studies ordered through PHC. Most patients use a combination of direct-pay for specialty care here and insurance for everything that happens outside our office.

Medicare-eligible patients are welcome at Pennsylvania Headache Center. Because we operate as a direct-pay practice, Medicare patients sign a private contract at their first visit acknowledging that visit fees will not be submitted to Medicare for reimbursement. Our team will explain this clearly before you schedule.

Reimbursement through your commercial insurance is often possible. After each visit, we provide a superbill, an itemized receipt with the diagnostic and procedure codes your insurance company needs to consider reimbursing you. Many of our patients submit these to their commercial insurance for out-of-network reimbursement. Reimbursement amounts vary by plan, and we cannot guarantee what any individual plan will return; we can give you the documentation to ask.

We work to keep care accessible. Several discounts and programs are available, including a same-day payment discount, a discount for cash or check, a referral discount, and income-based price relief for households under a defined threshold. Fees for prior authorizations and certain administrative services are billed separately. Our team will walk you through the specifics that apply to your situation before your first visit.

Questions about cost should not be a barrier to getting an answer. Call us at 717-745-6223 or use the Request a Visit form, and our team will explain current fees, applicable discounts, and what to expect – clearly and without pressure. We would rather have that conversation than have you guess.

Cancellation Policy. We understand circumstances may change. We request patients to notify us more than two (2) business days in advance if they need to cancel or reschedule an appointment. Cancellation or rescheduling requests submitted two or less business days in advance of the appointment will result in a charge of the full visit fee.