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Your patio plan may include a built-in hot tub, and your patio planner should include an option for building in the hot tub at ground level. If you choose to build in your hot tub you'll have to take out a portion of your patio or leave a section clear when it's being built. Most patio planners will show you both in-ground and above ground spa models so you can get an idea of how the tub will look above or below ground. In-ground models are especially easy to enter and exit, and they can blend in with the existing landscape more easily. The tub should still have at least an edging of patio around it to make it easier to clean, do maintenance, and keep dirt or grass out of the tub.