Cpt Codes For Massage Therapy
Once youâve verified that massage therapy coverage is possible, the two main billing CPT codes identified for insurance billing of massage therapy include:
- 97124: Stroking, compression, percussion
- 97140: Manipulation, traction, lymphatic drainage
Code 97124 is more so directed at massage therapy, while 97140 is actually for manual therapy. When billing for either of these two codes, be sure to cite these exact treatment procedures in your claim to ensure coverage. Additionally, do not cite both of these codes when submitting for reimbursement. Insurance companies will not cover services if both of these codes are cited.
Be sure to also have your clientâs insurance information & photocopies of their card on file, as well as their chart notes for each session readily available. These will be essential when filling out your CMS-1500 forms for each reimbursement.
Does Insurance Cover Couples Counseling
If youre planning on using insurance to pay for couples counseling, the rule requiring a mental health diagnosis will continue to apply and require that one partner receive a mental health disorder diagnosis. Some people feel this has the potential to skew their therapeutic experience.
As with any diagnosis you receive, a mental health disorder diagnosis may remain in your permanent record. In some instances, it may be accessed by background checking systems for your entire life.
Since insurers offer an array of plans, its not possible to give the specifics of each plan they cover. Here are some examples of coverage you may be able to get for therapy from specific insurers:
Verifying Insurance Coverage & Reimbursement For Massage Therapy
At the current time, there is no standard coverage for massage therapy services within large insurance providers. This means getting coverage comes down to the reason for care and how that care is defined to the insurance company. Usually, if the treatment is medically necessary, or it fits the criteria of coverage provided by the insurance company, your client will be covered and you will be reimbursed. Additionally, if the services fit into the category of âhabilitative or habilitation treatment,â it may be considered an essential health benefit and your client will receive coverage. Many insurance companies deem massage therapy necessary in the acute phase of treatment, rather than as a long term care procedure.
An easy way to increase your chances of massage therapy being covered by insurance is to ask your clients to obtain a referral from their primary care physician. In a recent survey conducted by the American Massage Therapy Association, 67% of respondents indicated that their primary physician recommended they receive massage therapy. A prescription or referral from a physician is important for reimbursement because massage therapists are not licensed to diagnose medical conditions. With a referral from a doctor, the massage therapist can include the ICD-10 diagnostic code and referring provider on their CMS-1500 form, and increase their chances of reimbursement.
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Does Medicare Cover Massage Therapy
- Find out the answer to the question does Medicare cover massage therapy, including information about what’s covered by Medigap and Medicare Advantage policies.
Massage therapy isn’t just an effective way to relax it can also help treat various health conditions. However, ongoing massage therapy can be expensive, so many people want to know if their health care insurance will help them cover the costs. Does Medicare cover massage therapy? Find out the answer below as well as whether it will pay for any alternatives.
Billing Massage Therapy To Medical Insurance
Many medical insurance plans cover massage and manual therapy. This benefit is typically covered under either your chiropractic or rehabilitation/physical therapy benefits. Starting in 2015, the majority of insurance carriers have begun allowing massage therapists to bill for massage and manual therapy under their own licensure. If your carrier does not allow licensed massage therapists to bill for massage we may be able to bill your insurance under our supervising chiropractor, depending on your medical insurance policy.
We will be happy to verify your insurance benefits to determine whether or not you have coverage for our services prior to your scheduled appointment and answer any questions or concerns you may have.
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Reimbursement From Other Payers
Massage can be covered by some types of insurance in those cases it is prescribed as a treatment.
For example, those who were involved in a motor vehicle accident can get their treatment covered by auto insurance.
Individuals whove been injured at work can get their treatment including massage that is covered by workers compensation.
In other words, it depends on the claimant circumstances that can be specified through state agencies.
For example, the state of Oregon provides the list of massage therapists who can provide treatment to workers compensation claimants who are not enrolled in Managed Care Organizations.
To be able to provide treatment to workers compensation claimants who were enrolled in an MCO, a massage therapist should be an MCO-panel provider.
Among the available MCOs in Oregon, there is Kaiser Permanente On-The-Job.
In Pennsylvania, there are numerous massage therapy benefits provided through workers compensation.
Provincial Healthcare Coverage For Massage Therapy
Provincial healthcare plans such as OHIP, AHCIP and MSI form the basis of the universal Canadian healthcare system .
These publicly funded healthcare plans provide coverage for medically necessary services only, however. As a result, most registered massage therapy is not covered by public healthcare.
The exception to this may be massage therapy that is received in a hospital and is deemed necessary to the recovery of a patient.
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Insurance Billing For Massage Therapists
Massage therapy has become an increasingly popular treatment option for a variety of health concerns. Many health care professionals have started referring patients to massage therapy as a form of treatment, and the industry has seen nothing but growth in recent years.
However, insurance companies have been a bit behind, as not many were willing to cover massage as a health-related cost. Lucky, the times are changing for insurance companies as well, as more and more states are adding medical/clinical massage therapy plans to the list of covered services. Learning to bill insurance companies for massage services can be extremely beneficial to building your massage practice.
The Affordable Care Act , Section 2706, may open doors to get massage therapy covered where therapists are licensed as health care providers. Under the ACA, it is now the law that health insurance companies must cover massage if the massage therapist is licensed as a health care provider . An excerpt from the health care reform bill reads as such:
The provider non-discrimination provision to be enacted into law reads in part:
A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that providers license or certification under appreciable State law.
Do Insurance Cover Massage Therapy
Does your health insurance cover massage therapy? This article discusses what progress has been made as far as massage therapy insurance reimbursement and if and when sessions may be covered as well as regional.
How To Get Medical Insurance To Cover Massage Therapy Massage Therapy Medical Insurance Medical Massage
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Becoming A Preferred Provider
There are multiple organizations that contract with WholeHealth Networks if they need assistance with CAM networks.
If you want to become one of those therapists who provide treatment covered by the insurance, there are a few organizations that accept applications.
To get info about the application process and required materials, you can look for info at various insurance providers.
Just keep in mind that the process can involve lots of paperwork.
If you look for some useful resources for massage therapists who accept insurance reimbursement or are considering doing so, you can visit the AMTA website.
How Long Does Myofascial Release Take To Work
Because the tissue begins to release only after about 90 to 120 seconds of pressure, each technique must be performed longer than this to facilitate lasting change. Experience and results have proven that MFR techniques should be performed for five minutes or more, a fact that recent research is now confirming.
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Advanced Alternatives & Insurance
We provide Medically Necessary Massage Therapy by prescription in order to help you access your insurance benefits.
Massage therapy is increasingly popular among patients seeking relief from pain or injury, and the health care industry is responding. Chiropractors, Osteopaths, Primary Care and other Specialistscan write prescriptions for massage therapy. The prescription should outline the treatment duration and modality recommendations for the specific diagnosis code.
Massage Discounts Offered Through Healthcare Plans
There is a variety of insurance providers that offer their clients discounts for massage therapy.
The American Massage Therapy Association provided a guide on how you can use these discounts.
Usually, companies contract with specific massage therapists.
In most cases, it should be therapists that work in clinical settings and services must be covered liability insurance.
In other words, the healthcare sphere markets massage therapists services.
As you can see an insurance plan may offer massage therapy in the form of reimbursement or as discounts.
For example, according to Kaiser Permanente, most plans include massage therapy only in those cases when it is determined as medically necessary.
There is an opportunity to apply for the Complementary Choices Discount Plan that covers services out of the reimbursement requirements or those out of the allowed number of visits.
Also, Kaiser Permanente claims that all listed massage therapy providers meet the requirements of the organization as well as the state licensing board.
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What To Do If Services Are Not Covered
If you are unable to guarantee coverage or reimbursement from your clientâs insurance company for services, you can employ a variety of other payment techniques that may be enticing to clients.
â¨ Accept an HSA/FSA Card
Flex Spending Accounts and Health Savings Accounts are commonly used bank accounts that employees can set up through an employer to set aside pre-tax money to pay for qualified medical expenses.
By accepting FSA and HSA cards for massage therapy services, youâll enable your clients to use pre-tax dollars, that they have already set aside for healthcare expenses, to work with you. You will still get paid for your services, but you and your clients can avoid the stress of dealing with insurance companies or having to pay fully out-of-pocket.
â¨ Include services in a package at a discounted rate
While this option still requires a client to pay out-of-pocket for your services, including massage therapy within a package at a discounted rate can help clients who need your services, but are struggling to pay. For example, if you charge $100 per session, you can offer a package of 5 sessions for $425, to make services more accessible to your clients lacking coverage.
This is also a great strategy for keeping your calendar full and ensuring consistent client appointments. With a package, clients are more likely to follow-up sessions, and use all of their credits. They wonât disappear after one or two appointments.
â¨ Offer a Superbill
Are Holistic Doctors Covered By Insurance
In many ways, a practitioner of alternative medicine follows the same steps for treatment that a conventional medical doctor uses. But because alternative medicine is still considered outside the scope of traditional health care, many insurance companies do not cover these visits or offer limited coverage.
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Insurance Options In The Pacific Northwest
Among the first states that included massage therapy in insurance policies, there was Washington.
There are numerous plan providers that include massage/ CAM benefits into their plans as well as a bunch of preferred practitioners in Washington and Oregon.
Some of them have rather lengthy lists of insurers.
What If Your Massage Isnt Covered
If your massage therapy isnt covered by your insurance, consider these options to help you find and receive affordable services:
- If you have a health savings account , you may be able to use it to cover massage costs if it qualifies as medically necessary. Learn more about HSAs and flexible spending accounts .
- Contact local massage schools to see whether they offer massages at a discount.
- Ask for discounts where you get your massage services.
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Why Massage Therapy Is Important
Health care options such as massage therapy have proved to be a viable and beneficial form of treatment for individuals with a variety of health ailments. More and more doctors are prescribing massage therapy to individuals with injuries, illnesses and chronic health conditions.
Massage therapy treatment from a registered massage therapist can treat health conditions such as back and neck pain, sports injuries, headaches, whiplash and many other common issues. It is also an effective form of treatment for other conditions, such as anxiety, depression, stress and even some diseases, such as cancer, stroke and arthritis. Massage therapy can be beneficial at any age.
Register And Log On To Your Insurance Account Online
Your health insurance plans website should contain information about your coverage and costs you can expect. Since insurers offer a variety of plans, make sure youre logged on and viewing your specific insurance plan.
If youre required to choose a therapist thats in your plans network, a list of providers should be available online. You can also call and ask that a local list be given to you by phone or mail.
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Massage Therapy And Your Insurance Coverage
In the past few years, what was once seen as more of a spa treatment, massage therapy has quickly become considered a reputable treatment method for pain tolerance.
As more healthcare providers recommend massage therapy as a treatment for patients, individuals are seeking benefits from their insurance providers. Unfortunately, at the current time, there is no standard coverage for massage therapy.
The reasoning behind the requested care and how that care is defined by the insurance company will determine what kind of coverage you can get. If the treatment is medically necessary and fits the criteria provided by the company, the patient can get reimbursed for the treatment.
Receiving referrals by physicians is one of the best and easiest ways to get massage therapy covered. Once you receive a physician referral, its important to talk with your insurance company in case you need to get pre-authorization or other documents for the services.
Healthie For Massage Therapists
Healthieâs all-in-one software helps massage therapists streamline scheduling, billing, note-keeping, and client communication. With features such as:
âï¸ Insurance billing: Generate CMS-1500 claims that can be batch-downloaded and submitted to your clearinghouse of choice. Easily track claim statuses and reimbursement within Healthie, or invoice clients for non-covered amounts.
âï¸ EHR: Leverage Healthieâs HIPAA-compliant electronic health record allows you to keep clientsâ personal health information secure, and track client progress using custom-built chart notes.
âï¸ Packages and Invoices: Create custom package offerings and authorize client payments using our integration with Stripe. Generate invoices and receipts for payments.
âï¸ Online Booking: Healthieâs scheduling feature allows you to create custom appointment types, set availability, and book online via our web platform or mobile app.
âï¸ Client Engagement: Check in with clients between appointments using Healthieâs HIPAA-compliant chat feature.
Healthie allows you to focus on your clients while knowing your back-office responsibilities are handled.
Learn more about Healthie for massage therapists here.
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Are Massages Covered By Insurance
With many people turning to massage therapy as a medical treatment, it seems that health insurance should cover massages. However, not all policies do.
For example, Medicare does not cover massage therapy, so you will likely be responsible for 100% of the costs if you seek this treatment. Even if your health insurance provides coverage, there may still be limitations.
The definition of massage therapy may vary, depending on the insurer. That definition of massage, and the reason youre getting one, will likely determine whether insurance will cover it.
If massage treatment isnt covered in your policy, be sure to ask about alternative options. Its also a good idea to discuss them with your doctor.
Communicate With Your Doctor
Insurance can be frustrating for anyone and everyone to deal with that isnt an insurance agent or seller, so, doctors may be willing to work with you on finding a diagnosis that will be covered by your insurance policy.
If youve looked into some treatments for your pain and have decided that massage therapy may be useful, communicate that with your doctor. Advocate for yourself by saying youd like to try massage therapy and see if they will recommend it for you.
Once your doctor has agreed to prescribe massage therapy as your treatment, ask them to diagnose the problem in the most general way possible. A term like muscle pain will allow a massage therapist to treat you more broadly and easily.
It can also be helpful to ask that the prescription not specify the frequency or number of massages this can allow you to receive the therapy more times without having to pay out-of-pocket.
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Insurance Coverage For Massage Therapy
Massage therapists rely heavily on various types of insurance coverage to fund care for patients.
Massage therapists rely heavily on various types of insurance coverage to fund care for patients. Employee health benefit plans, claims for auto insurance and workers compensation are all potential sources of funding for massage therapy treatment. In a survey commissioned by the College of Massage Therapists of Ontario, 75 per cent of patients or clients use employee workplace benefits to pay, or partially pay, for their care.
With job-related stress accounting for an estimated $16 billion in Canada and repetitive strain injuries estimated to affect one in 10 Canadians, massage therapists have an opportunity to position themselves as allies with industry in keeping claims for workplace injury and ancillary costs in lost workdays, turnover and employee dissatisfaction down.
Despite the impact of these workplace-related illnesses, many employee benefit plans are being scaled back. Employers are wanting reliable outcome measures and proof that their invested dollars are yielding healthier, more productive employees. Coupled with an increase in massage therapy insurance fraud, RMTs are at risk for losing a major source of funding for patients.
Report from the Field I posed the question on Facebook, Have your workers-with-benefits changed their utilization of massage therapy? Respondents shared the following:
Threats to Employee Health Benefit Plans