Tuesday, April 16, 2024

Does Medicare Cover Massage Chairs

Medical Massage Chair Using A New Massage Chair To Help Meet Your Deductible

Medicare lift chair.wmv

Some health insurance plans may allow you to apply the cost of a therapeutic massage chair against your annual deductible. Typically, this requires a doctors prescription for the therapeutic chair. Also, the insurance company will usually require that the chair be considered DME under the plan terms.

To determine whether this is a possibility under your plan, talk to your benefits administrator or research the benefits and terms of your healthcare plan. You can also talk with your care provider to see if they can offer insight into how to get a massage chair covered under insurance.

What Is Massage Therapy

The Mayo Clinic defines massage therapy as a complementary treatment that involves manipulating the bodys soft tissues. Massage therapy, in order to be classified as a medical treatment, must provided by licensed and certified massage professionals.

Clinical studies show that massage therapy can help treat pain, reduce stress, and relieve muscle tension. In 2018, the Centers for Medicare and Medicaid Services issued guidelines that must be met for the use of massage therapy to be deemed as a medically approved alternative to opioid therapy. Therapeutic massage can also be used to help reduce cancer-related pain, fibromyalgia symptoms, and stress-related symptoms of heart disease.

Take Care Of Your Documents

Your records are essential to get the insurance plan approved. You never know when the insurance company asks for a medical record therefore, take care of your documents.

I remember when I got my massage chair insured around a month ago, my insurance agent asked for a medical prescription and a copy of the referral.

Hence, I can tell you with an experience that these documents are necessary to support your reimbursement.

In case of losing your records, you’re going to be at risk of not getting the insurance plan approved, which can be troublesome.

At the end of the day, one thing that you need to understand is not all insurance firms regard massage therapies as a health treatment.

Thus, with all other things, don’t make assumptions. Play your part practically here!

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When Does Medicare Pay For Massage Therapy Cpt Code 97124

According to Medicare Part B and CMS LCD L34049

Massage therapy Massage may be medically necessary as adjunctive treatment to another therapeutic procedure on the same day, which is designed to reduce edema, improve joint motion, or relieve muscle spasm.

Massage chairs, aquamassage tables and roller beds are not considered massage. These services are non-covered.

Massage is not covered as an isolated treatment.

Documentation must clearly support the need for continued massage beyond 6-8 visits, including instruction, as appropriate, to the patient and caregiver for continued treatment.

This code is not covered on the same visit date as manual therapy techniques.Do not bill massage therapy for percussion for postural drainage.

Supportive Documentation Recommendations for massage therapy

  • Area being treated
  • Objective clinical findings such as measurements of range of motion, description of muscle spasms and effect on function
  • Subjective findings including pain ratings, pain location, effect on function

Certificate Of Medical Necessity

Amazon.com: lift chairs covered by medicare

To prove that you demonstrate medical necessity, youll first need to schedule an in-person appointment with your physician. Your physician will grant you a prescription that states you have a medical condition that requires the use of an at-home lift chair.

Your doctor will also need to fill out sections B and D on the official Certificate of Medical Necessity for Seat Lift Mechanisms form otherwise known as Medicare Form CMS-849. Pro-tip: Check to make sure that youre purchasing from a Medicare-participating supplier that accepts assignment. Otherwise, Medicare wont cover the costs.Once you have the required paperwork completed, youll need to send this information to your provider. Its your providers responsibility to submit the claim for your chosen chair to Medicare but first, you need to demonstrate physical and medical eligibility.

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Are massage chairs covered by insurance?

If you already used your deductible and are looking to have your insurance company cover a massage chair’s cost, this the answer is typically no. Massage chairs typically do not have an insurance medical code or DME which means they cannot be covered by insurance.

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What equipment does Medicare pay for?

Durable medical equipment is reusable medical equipment, which includes items like walkers, wheelchairs, or crutches. If you have Medicare Part B, Medicare includes some medically necessary durable medical equipment if your physician or treating practitioner prescribes it for you to use at home.

Having your health insurance plan pay for a new massage chair can be challenging but for many it is possible to get your chair or at least a part of the cost covered under certain benefit plans.

Because the health insurance market is so strict on what is and is not covered, you might have to work to get your plan to cooperate. Even if your insurance wont cover a massage chair’s cost, you might have other options for offsetting the cost of this valuable purchase.

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Will My Medicare Plan Cover A Lift Chair

Yes, lift chairs are covered by Part B of your Medicare coverage. They are considered durable medical equipment used to treat certain conditions like arthritis or other balance or mobility issues. These standards should be included in any Medicare Advantage Plan, too. You wont be covered for a lift chair if youre residing in a hospital or skilled nursing home for the time being. You also wont qualify if Medicare has already paid for a scooter, wheelchair, or another motorized device. The piece of equipment that is covered by Medicare is the motor and contraption that helps lift you out of the seat. Medicare wont cover chairs that use a spring device to lift you out. The fabric, cushion, and other accessories arent covered even though the device is built into the chair. In total, Medicare will pay for about 80 percent of the motorized device, and you will pay for the remaining 20 percent as well as the costs for the rest of the chair. Supplemental Medigap plans will help cover all the costs Medicare doesnt, too. Once you decide which chair you want, you will buy the chair and then you or your provider will submit a claim to Medicare. You will be reimbursed for the cost covered by Medicare. This price varies on which state you live in, but the reimbursement is typically between $280 and $300. There are medical standards for your lift chair to be covered by Medicare Part B. These standards include but are not limited to:

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What Is A Certification Of Medical Necessity

In some cases, you may be required for certification of medical necessity before the lift chair is approved for cover. Certification of medical necessity is a certificate that validates a treatment procedure for a medical condition. The procedure may be a DME or any other healthcare services. The certificate is usually demanded by the Centers for Medicare and Medicaid Services.

Does Medicare Cover Recliners

Does Medicare Pays For Lift Chairs?

Nearly 80% of the cost of the recliner is covered by Medicare which is around $300. However, it is advisable to check state-specific norms of Medicare coverage information for details. The remaining amount of the recliner chair cost will be be born by the consumer.

  • You must possess Medical Insurance, the Part B of Medicare or Medicare Advantage Plan, Part C of Medicare.
  • You must buy the recliner from a Medicare-participating supplier.
  • You must have a medical prescription from a Medicare-approved doctor stating the need for the recliner due to your health condition.
  • The medical prescription must include either of the following reasons:
  • You are unable to stand up from a regular chair by yourself.
  • You are going through severe knee arthritis.
  • You have pain and immobility in the hip bone.
  • You are only able to walk with the help of a device.
  • Your medicare-participant doctor must submit the claim after completing Sections B and D to Medicare under Medicare Form CMS-849, i.e., Certificate of Medical Necessity for Seat Lift Mechanisms Form.
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    Whats Covered By Medicare

    In Canada, we have a system of universal coverage for basic medical care. It is informally referred to as medicare. It is not a national program under legislation, our provinces and territories are required to fund hospital and doctor services and make sure their residents have reasonable access to these services. The federal governments role is to provide funds from tax revenue so the provinces can operate these services. Under our Canada Health Act, all provinces are accountable to ensure their hospital and physician services are accessible to all, universal and portable.

    Over time, what is considered basic hospital and physician care has expanded to include many services and products.

    What is Covered by Medicare

    • Family doctor visits, emergency room visits, outpatient clinic appointments
    • Inpatient care/surgery
    • Medicines you receive as part of your inpatient care
    • Diagnostic Tests, Bloodwork, Scans, Genetic Testing
    • Radiation therapy
    • Lymphedema devices and pressure garments
    • Nutritional supplements or feeding supplies
    • Physiotherapy/Occupational Therapy
    • Tattooing and other reconstructive supports/processes

    What Kind Of Lift Chair Should You Get And Where Can You Get One

    Now that you know what lift chairs are and the stipulations surrounding one being covered by your plan, its time to settle on which type of chair you want. As we discussed, there are three main types of chairs: two-position, three-position, and infinite-position. Obviously with Medicare in play, youre limited in the scope of lift chairs that you can get without paying too much money out of pocket. Each version comes at different price points.

    It is also advised that you get a lift chair from a Medicare-approved supplier. To find out approved suppliers in your area or online, contact your local Social Security office and compile a list of who you can buy from.

    Its difficult to say that one style of lift chair will cost a certain amount of money, though we can guarantee infinite-position chairs will typically cost the most and two-position chairs generally cost the least.

    Stressed about home care?

    The overall price stems from the type of fabric you want, how much cushion you want for your chair, how big the chair is , and other important factors. As a result, getting a top-of-the-line two-position chair may end up costing more your basic-level infinite-position chair. So, instead of just saying you should get X lift chair for Y amount from Z place, lets run through some steps you can take when finding the right lift chair for you.


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    What Is A Part B Deductible

    Many individuals feel confused at this concept, but your Part B deductible is the amount you first need to pay out of your own pocket before your Medicare insurance coverage begins. In 2019, this figure rose to $185, up $2 from previous years.

    Youll also be responsible for the 20% co-insurance, which is the amount left over from the actual cost of the chair.

    Advice For Massage Therapists

    Medicare Approved Lift Chair Dealers ~ designbyafi

    For any LMT that wants to accept insurance.

    They will need to check with their states governing board to see what requirements must meet in order to bill insurance companies other than Workers Compensation and auto insurance PIP.

    Also, it would be a good idea to check with insurance providers in case the client hasnt done the proper checking to see if massage therapy services covered.

    LMTs who wish to accept insurance may also want to hire a medical billing.

    And coding professional to ensure that the proper codes entered in the proper places and claim forms filled out correctly.

    Making sure detailed recordkeeping performed will ensure that the LMT will reimburse for their services.

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    What Medical Equipment And Supplies Does Medicare Cover

    En español | Medicare Part B helps to pay for many items of medical equipment and supplies that help you function for example, wheelchairs, artificial limbs, pacemakers, commode chairs, hospital beds, appliances to help breathing, neck and back braces, oxygen supplies and many more. The equipment must be durable . With only a few exceptions, Medicare doesnt cover disposable items.

    To qualify for Medicare coverage, the equipment or supplies must be:

    • Medically necessary for you not just convenient
    • Prescribed by a doctor, a nurse practitioner or another primary care professional
    • Not easily used by anyone who isnt ill or injured
    • Reusable and likely to last for three years or more
    • Appropriate for use within the home
    • Provided by suppliers that Medicare has approved

    For some items such as oxygen equipment or a seat lift to help you get into and out of a chair Medicare requires a doctor to fill out and sign a certificate of medical necessity without it, Medicare will deny coverage.

    Medical equipment is most often rented, but some items may be purchased. Either way, you must get it from a Medicare-approved supplier. To find approved suppliers in your area, go to the supplier directory on Medicares website at .

    For more information, and to find out how to select an approved supplier, see the official publication Medicare Coverage of Durable Medical Equipment and Other Devices.

    Pay Attention To The Maintenance

    Aside from getting your massage chair insured, you need to maintain and take care of a massage chair more than other home essentials.

    If your massage chair is in regular use, it is certainly more prone to wear and tear.

    So if you’re not taking proper care of your massage chair, what makes you think an insurance company would do it for you?

    Nevertheless, following are a few tips and tricks to keep your pricey product in a topnotch shape:

    Regularly clean the upholstery of the massage chair, including every corner and crevice.

    Make sure none of the cleaning solutions get inside, try and clean those pieces away from the chair.

    Sweep out the dirt regularly using a damp, soft piece of cloth.

    Ensure that it is completely dry before you use it every time.

    Don’t forget the oiling part, especially in the case of a leather massage chair.

    Please do not keep it directly in the sunlight as it may increase the odds of leather damage.

    Always keep your massage chair hooked to a surge protector.

    Be careful with the sounds it makes. In case it sounds different, get professional help.

    A massage chair is a prominent investment in itself. That being so, it is wise to get it insured, but it still doesn’t change the fact that it requires care from you as well.

    Summing up the article, you may or may not get a reasonable insurance plan for your massage chair, yet you need to try your best in all cases. At least, could you not repeat the mistake I made?

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    How Much Do Lift Chairs Cost Through Medicare

    If you qualify, Medicare will pay 80% of the cost of the motorized lifting device. Youll pay your Part B annual deductible, the remaining 20% for the device and the cost of the chair itself. The total amount you pay can depend on any other insurance you have, where you get the lift chair and more.4

    You Have A Valid Prescription

    WiseLift Reclining Lift Chair with Massage and Heat on QVC

    Even if you are eligible, there are a lot of things to consider. Firstly, you’ll have to talk to your insurance company’s plan manager regarding the policies. Ask them if a massage chair’s cost can be covered by your health insurance or not. Most often than not, they’ll ask you if you have a medical prescription from your doctor, physical therapist, or chiropractor. If your insurance policy does cover massage therapies, you must make sure that they cover your massage chair’s cost instead of professional massage therapies. If it goes well with your insurance company, your next step becomes crucial.

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    Infinite Position Geri Chairs

    Infinite position Geri chairs can achieve many different positions while still providing great performance and style. An infinite position chair is great for taking a nap, and any number of positions can be achieved because the footrest and backrest move independently from one another. Positions that can be achieved include the zero gravity position, where the lower legs and thighs are higher than the torso, and the Trendelenburg position, which elevates the feet higher than the head. There is also the infinite lay flat position, which is ideal for napping or relaxing.

    More Cost Effective Than Massage Therapy

    How much is a massage chair worth, really? Apart from the investment in your health, a massage chair can offer tangible savings over the long-term that make them well worth the cost.

    Inconvenience aside, the cost for a 1-hour massage is generally $100-$175, which can cost up to $210 when you include a 20% tip. Lets be lenient and say that an injury requires you to have weekly massages for two months. Your total cost is then $1,680 for that period of massage therapy. Thats more expensive than the cost to own a WholeBody® 5.1 massage chair, forever.

    Is a massage chair worth buying? When you consider the costs of buying a massage, yes.

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    Specialized Therapeutic Chairs Used Primarily For Children

    Footnotes* Note: The following are examples of chairs that are not covered DME because they are not mainly used in the treatment of disease or injury, are not primarily medical in nature, and/or are normally of use to persons who do not have a disease or injury:

    • Back rests
    • Lumex Ortho-Biotic High Back Rocker
    • Lumex Ortho-Biotic Recliner
    • Standard feeder seats without positioning straps
    • Zero gravity chairs.
    Presence of artificial hip joint

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