Many national insurers have contracted with repricing companies that undervalue out-of-network physical therapist services, leading to underpayments for providers. To navigate these situations, providers can collect full payment upfront and issue superbills for patients to seek reimbursement. If a discounted rate was previously accepted, providers should contact the health plan to reverse the claims or negotiate better rates while keeping documentation. Accepting such reduced rates also may impact future claims, so providers should encourage patients to raise concerns with their employers and consider reporting underpayments to state insurance authorities.