Contact us!
Email: Admin@perfect10pt.org
ATTN: ALL appointments are booked through this website or via our Wix App under:
"Book Online"
ATTN: Dr. Greene is Out of the Office: 11/26-11/29 and 12/25. Dr. Greene will return to the office on 11/30 and 12/28 respectively.
Thank you!
Super Bill Request
Request of Super Bill from Perfect 10.0 Physical Therapy, PLC.
Service Description
As of July 1, 2025 we no longer offer courtesy Super Bills. All Super Bills must be requested an paid online. This is NOT an in person or virtual meeting, you choose the day & time you'd like the Super Bill emailed to you when booking this service. The Super Bill along with general instructions on how to submit will be sent to you at the time of booking. Super Bills include all appointments through the current year. If you'd like one from last year please specific in the comments section. A completed list of dates of service along with ICD-10 codes will be provided. Request for Superbill from Perfect 10.0 Physical Therapy, PLC for insurance reimbursement purposes. We would like to inform you of our Superbill Policy update, starting 1/1/2025. Our practice is a cash-based physical therapy clinic that does not participate with any insurance companies. If you have out-of-network coverage, you can file for reimbursement, pending services. We will provide the eligible codes for you at a cost of $64.98 per Superbill Request, starting 1/1/2025 along with a 3% increase in all services provided. You are now able to submit a Superbill Request at any time. We are offering this provision to make information more readily accessible and convenient to you. This is not reimbursable by insurance and will therefore not be itemized into a Superbill. Please email admin@perfect10pt.org for specific pricing questions for this service or for your specific gym affiliation. *Please Note: Dr. Greene has up to 48 hours to complete documentation following each appointment. If a Superbill is requested within 48 hours of the most recent date of service, that date will not be included on the Superbill. To ensure your most recent visit is reflected, please submit your Superbill request at least 48 hours after your last appointment. ATTN: We are a cash-based, fee-for-service medical practice and do not accept insurance of any kind. This service is not covered my government issued insurance (ie. Medicaid, Medicare Part A and B and Tricare) and therefore is not reimbursable and will not be itemized into a Super Bill. We also require a credit card to be placed on file or the patient cannot be seen per our policy. ***Please note: there is a premium rate applied for Holiday, emergency and weekend (Saturday/Sunday) for this service appointment!
Cancellation Policy
To cancel or reschedule, please email, text, or call the office at least 24 hours PRIOR to your appointment. Cancellations less than 24 hours before the appointment incur a fee equal to the full scheduled service charge, regardless of reason. If you reschedule the canceled appointment within the same week, the cancellation fee will be waived. No-shows incur the full scheduled service charge. Appointments cannot proceed without required payment. BOOKING: Services linked to this policy must be booked online at least 72 hours in advance. Evaluations and Gymnastics Performance Assessments require time for paperwork and administrative preparation. The 72-hour booking rule is separate from the 24-hour cancellation deadline. Requests within 72 hours require office approval and are subject to availability. DEPOSIT: A $54 NONREFUNDABLE reservation fee is required to secure paid Evaluation and Gymnastics Performance Assessment appointments. The $54 is NOT the evaluation/assessment price and is NOT credited toward the service charge. Full payment for the service is due separately at the time of service and will be billed to the card on file. Rates vary by service and gym affiliation. Email admin@perfect10pt.org for your specific rate BEFORE booking. This deposit does not apply to services designated as free consultations/screens. PAPERWORK: Required New Patient/Client Paperwork must be completed and returned at least 48 hours before the scheduled evaluation or assessment, or the appointment will be canceled. Forms are available on our website under “More” and will be emailed after booking. A valid credit card must be on file before services can be provided. ATTN: Perfect 10.0 PT is a cash-based, fee-for-service practice and does not accept insurance. Reimbursement is not guaranteed. Ethan Valencia's Gymnastics Performance Assessment is nonmedical, not PT, and is not eligible for a PT superbill. LATE/SAME-DAY REQUESTS: Appointments requested less than 24 hours in advance, including same-day requests, require office approval. If accommodated, ONE 50% surcharge (1.5 times the regular service rate) applies; surcharges are not stacked. This surcharge does not apply to patients contacted from the waitlist after a same-day cancellation. Holiday and weekend (Saturday/Sunday) appointments may carry a premium rate. This policy applies to the connected services; deposit, paperwork, and service charges apply only where relevant.
Contact Details
Cardinal Gymnastics, Guinea Road, Fairfax, VA, USA
+15712529131
egreene@perfect10pt.org
Dynamic Gymnastics, Carlin Springs Road, Bailey's Crossroads, VA, USA
+15712529131
egreene@perfect10pt.org