Does Health Insurance Pay For Massage Therapy
Posted on: February 17, 2020
Since different companies provide health insurance coverage in the United States, its impossible for an article about this topic to give readers a definite answer about their unique individual situations. Private insurance carriers, Medicare and Medicaid requirements and other factors come into play when discussing massage therapy. People usually cant receive coverage for any form of massage therapy without a doctors referral that clearly states that the therapy is medically necessary. Most health insurers pay for medically necessary treatments performed by a licensed massage therapist. Insurers typically dont cover trips to the day spa for people who believe that a nice massage would feel great on a particular day.
Its always best that you check with your insurance provider about your coverage. A member service representative at the number on your insurance card can go over the types of massage that your policy covers. If youre too ill to make that call, your doctor or one of their staff members can check with your insurer before you start treatment. Additionally, its important to keep in mind you have other options if your insurer wont pay and you absolutely need therapy: Most licensed massage therapists, like other medical professionals, offer patients multiple payment options, such as a large discount for paying in cash upfront and low- or no-interest installment repayment plans.
Auto And Workers’ Comp Insurance
According to the Institute for Integrative Health Care, all 50 states allow you to bill insurance companies for massage therapy services related to on-the-job injuriesworkers’ compensationand injuries associated with automobile accidents. Your clients will need doctor referrals. Some states, like Washington, allow insurance credentialing. This allows massage therapists to contract directly with insurance companies within the health care system as part of that provider’s network. To get credentialed, you must go through an evaluation process in which insurers assess your qualifications based on a background check, the quality of your license, your education, and training history.
Stay Away From Medicare And Medicaid
Medicare and Medicaid are not something you may bill insurance for, as they do not cover the services of a massage therapist, Madison-Mahoney says. Many have tried and have later been asked for a return of reimbursements, she adds. The only way you can be paid for your work on a Medicare client is by cash. If this is done in a physicians office, the physician would have to be sure the Medicare patient signed an Advance Beneficiary Notice form. This form indicates to the client that the services would not be covered under her Medicare Plan.
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What Is A Superbill For Massage Therapy
A superbill is a thorough invoice that details the services provided to a customer. When a therapist is not on a clients insurance companys panel, they may need to create a superbill. The therapist or client sends the superbill directly to the insurance, including all of the information necessary for the claim to be paid.
Taking Health Insurance: Handling Paperwork
The paperwork component of billing insurance for massage is potentially the most daunting of all. You may be surprised to learn that health insurance claims are actually legal documents, which means that accurate and extensive record keeping is paramount.
Some of the things youll need to keep track of in order to file for insurance are:
- The clients primary care providers prescription or referral document
- Documented pre-approval request from the insurance company
- Documents demonstrating HIPAA compliance
- Clients authorization to release medical information
- Signed statement that the client will pay for any services not covered by insurance
This list is far from exhaustive. Considering the amount of paperwork involved, many massage practitioners who bill insurance opt to outsource the process entirely to athird-party company. Keep in mind, though: this will increase your costs considerably.
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The Top 6 Insurance Billing Mistakes To Avoid
To complement From Survive to Thrive: Insurance Billing Made Easy in the March 2015 issue of MASSAGE Magazine. Summary: Accepting insurance provides an opportunity for massage therapists to earn consistent incomeprovided they avoid common pitfalls associated with the billing process.
Time and again, I have seen that the people who complain about billing insurance, quite simply, either havent been brave enough to try it or are doing it wrong. There are several billing mistakes Ive seen repeatedly made by massage therapists when dealing with insurance.
Avoid these six simple mistakes, and youll find yourself making more money and with more freedom in your massage practice than you ever thought possible.
In Order To Bill Your Auto Insurance Company For Massage Therapy With Dr Eric Jorgenson We Require:
- a prescription from your physician, naturopathic physician or chiropractor
- the prescription must include a diagnosis code that we require for billing
- the claim number from your auto insurance company
- the name and telephone number and/or email address of the auto insurance company claims representative handling your claim
Please bring your prescription information to your appointment, or send it by email to or call us at 541-490-1444.
Auto accident claims can be complicated and depend upon a number of factors. If you have questions, feel free to contact us. We’ll do our best to help or direct you to additional information resources as necessary.
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Insurance And Massage: Can Insurance Pay For Massage Therapy
When someones suffering from chronic pain, acute injury, or high levels of stress and anxiety, massage can be a powerful tool to aid in recovery and general wellness. As a massage therapist, youre already well aware of this. You see patients come in with a wide variety of issues everything from a back spasm to trauma-related injuries and help them get back on their feet with the power of massage.
As a practitioner of massage, youre always looking to offer your services to as many clients as possible. But, the act of broadening your ability to help a larger range of clients can take different forms. On the one hand, you can focus massage therapy continuing education courses. By learning about specific techniques like sports massage and deep tissue massage, youll be able to provide a greater variety of services to your clients which can translate to more clients served at the end of the day. As an aside: when working on continuing education, its important to ensure that your massage CEUs come from an NCBTMB approved provider in order to ensure their acceptance by your states massage therapy licensing board.
This is one way to think of widening the scope of your practice. But, theres another approach you can take if you want to see more clients. Rather than requiring all of your clients to pay for services rendered out of pocket, you might consider offering clients the option of billing their health insurance provider for reimbursement of the cost of their visit.
How Do New Clients Get Massages
Whether youre in Portland or not, the 10 strategies below can help you get new massage customers. At athletic events, you may volunteer. Participate in local organizations. T-shirt featuring your contact information from your business card. Become a member of online mapping services. Inquire about referrals from current and previous clients.
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Holistic Massage Of Hood River Is A Preferred/in
- First Choice HealthOur massage therapists are out of network. Dr. Eric Jorgenson is in network for massage services.
- Providence Health Plan
- Premera Blue CrossWe are in network, but not accepting new Premera members. Dr. Eric Jorgenson is out of network.
- Regence Blue Cross Blue ShieldWe are in network, but not accepting new Regence members. Dr. Eric Jorgenson is out of network.* As of January 1st, 2022, many Regence/Premera plans that formerly covered up to 90 minute sessions are now only covering 60 minutes. Please contact your insurance provider or call us for your updated plan details.
Extended Healthcare & Massage Coverage
Many extended healthcare plans offered by Canadian employers include provision for massage therapy. As part of your regular routine, massage is an excellent way to maintain good health and help prevent injury from the repetitive strains of your daily life.
If youre not sure whether your benefits package included massage therapy, you can either check the benefits packet from your employer or simply call your insurance provider. In order for massage to be covered by any insurance plan, the services received must be completed by a Registered Massage Therapist . You may also be required to submit a doctors note recommending that you receive massage therapy.
Some insurance plans cover massage therapy but only up to a certain amount per visit. This may be a dollar amount or a percentage. Any amount not covered by your insurance company must be paid on completion of the treatment.
DIRECT BILLING
Some insurance companies allow Assignment of Benefitsthe provision that allows a massage therapist to bill them on your behalf so that you are not required to pay for treatment up front.
Currently, both GreenShield and Blue Cross allow massage therapists direct, online billing services. The only paperwork you will need to provide is a doctors note, if required under your plan.
If you have insurance coverage under any other health care plan, and would like us to complete billing for you, please call them to verify that they allow assignment of benefits.
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Does Medicare Cover Massage Therapy
At present Medicare does not pay for massage treatments, but in general, there are three main sources of insurance billing for massage therapy, these may vary from state to state:
- Major medical plans
- Personal Injury
- Workers Compensation Insurance
It is important to note that it is not enough to just know the insurance vendors name you also want to know the specific insurance plan, and the employer, to determine a patients insurance coverage. When you bill insurance for medical massage services, you will need to verify your patients insurance benefits directly with the payer before you start treatments. You can do this by contacting the insurance company via the phone number listed on the patients medical card and providing the patients policy information along with their date of birth.
Massage Discounts Offered Through Healthcare Plans
Some insurance providers offer their members discounts for massage therapy. The American Massage Therapy Association has described how this scenario works. The company contracts with specific massage therapists. Typical practitioner requirements include working in a clinical setting and being covered by liability insurance. The healthcare in essence markets the massage therapist.
A health care plan, notably, may offer massage therapy as a reimbursable service and also as a discounted service. Kaiser Permanente, for example, notes that plans typically include massage therapy when its determined by a physician to be medically necessary . Members may utilize providers from the Complementary Choices Discount Plan when the service they seek doesnt meet the reimbursement criteria or they have used up their allowable visits. Kaiser Permanente informs members that the massage therapists listed have been vetted twice: Theyve met the organizations standards as well as those of the state licensing board.
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Massage Therapy Cpt Codes Faq
The importance of accurate billing and optimized practice management can not be overstated. Often, the two go hand-in-hand, as your practice is at its best when the administrative and service sides of your business are delivering their best! One particular quality of this has to do with billing for massage therapy services. This blog covers some of the most common CPT codes youll need, as well as some frequently asked questions about billing.
How Do Massage Therapists Find Out If Their Clients Have Coverage For Massage Therapy Services
Be sure to discuss rates and payment expectations with your client during your initial phone contact. Getting things in order before their initial visit makes good sense in order to avoid time-consuming issues later on. Be sure to ask your client to find out whether massage therapy is a coverable service under their specific insurance and plan. If it is, they may want to check if massage is coverable by a . Some plans require that massage be performed by a physical therapist, occupational therapist, chiropractor or other. Just because an insurance company offers massage as a plan benefit does not necessarily mean they allow massage therapists to provide the service.
In some cases of auto accident and workers comp, it may also be necessary to be in regular contact with a case manager regarding your services as they may be assigned to oversee the care of their insured.
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Auto 3rd Party Claims
Third party means that a client is covered by the insurance of another person . This type of coverage generally means that the massage therapist treating the client may either receive payment from the insurance company at the end of the case , or the client may agree to pay the massage therapist and then submit the bills to the insurance company at the time of settlement.
Auto 3rd Party claims require prior authorization before massage therapy begins.
How Do Individual States Massage Therapy Practice Laws Influence Whether A Massage Therapist Can Bill For Insurance Reimbursement
First, be sure to thoroughly review and understand the scope of practice that is written in your states law. Every state law is different. A license allows you to practice in your state, however, it doesnt necessarily guarantee acceptance by an insurance company for reimbursement for services rendered.
Be sure to check with your massage practice board who can help answer any questions you may have regarding typical insurance practices and how massage is viewed in your state.
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Insurance Companies May Cover Massage Therapy If Prescribed By A Doctor
Its rare for car insurance to cover the costs of massage therapy. However, its not totally unheard of.
Your best option is to get a prescription for massage therapy from a doctor. If a physician prescribes massage therapy to treat your injuries after an accident, then your auto insurance or the auto insurance of the at-fault driver may cover the costs of massage therapy.
Some massage therapists work specifically with car insurance companies. Payments are made directly from the insurance company to the massage therapist.
We Cover Your Treatment In Accordance Standards Set By Your Insurance
The prices stated in our Spa and Massage Menu and Packages section reflect discounts for payment at time of service for clients and is for non-medical or physician-referred massages. Medical massage under MVA insurance is billed in accordance with UCR fees this service is available in 15 minutes increments at a rate of up to $50.00 per unit and is based on actual time spent covering the treatment on credit, requiring hours of billing time, tracking, and collecting payment for services and requires well-documented records and chart notes for billing purposes which is normally not required.
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Some Drivers Commit Insurance Fraud When Requesting Massage Therapy Coverage
If massage therapy is medically necessary and priced reasonably, then your car insurance company could cover it.
Unfortunately, insurance companies often push back against massage therapy coverage because theres a huge problem with fraud.
Its difficult for the insurance company to determine if massage therapy is medically necessary and reasonably priced, so they just refuse to cover it at all.
CBS News, for example, recently covered a story about drivers in Florida illegally claiming massage therapy expenses after an accident. Its a popular form of insurance fraud:
Scam artists have found a way to milk this cash cow with swoop and squat car crashesand in some instances, they even create fake crashes using only paperwork.
After creating a crash scene, the fraudsters visit massage therapists and other professionals who are aware of the scam:
The ringleaders, or brokers, organize spider webs of chiropractors, massage therapists and fake clinics to provide nonexistent X-rays and fraudulent diagnoses that overwhelm insurers with thousands of claims that are rushed through immediately after the accident.
Stories like this are particularly common in no-fault states, where personal injury protection coverage is specifically designed to cover the immediate costs after an accident. Scammers take advantage of these systems to rack up fraudulent claims like for massage therapy.
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Work Injury Massage Therapy
If you have been injured at work, we know how important it is for you to resolve the pain and discomfort you may have sustained in a timely manner. We work with your referring physician or chiropractor to coordinate a healing schedule that provides effective relief for many work related injuries. Our therapeutic treatment schedules have been successful in returning our clients to their normal and productive lifestyles in work and everyday living.
The following is a list of items we require to start treatment:
An open Labor and Industry Claim
L& I insurance informationA physician or chiropractors referral for massage therapyClaims managers name and claim numberDate of injuryL& I / Work Insurance: We bill your L& I / Work Injury Company directly. There is usually no out of pocket expense associated with your claim.
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Cpt Codes And Massage Therapy
Assuming youve decided to incorporate insurance billing in your massage practice and have determined that youre eligible to do so in your state, the next step in the process is understanding more about the billing paperwork and particularities involves.
One aspect of the associated paperwork that youll need to familiarize yourself with is something called a CPT code, or Current Procedural Terminology code. In laymans terms, CPT codes serve as a national standard for codifying individual medical procedures. The coding system is maintained by the American Medical Association , and the American Massage Therapy Association was brought onboard to offer input into the development of specific language related to treatment modalities associated with massage therapy.
While there are many, many CPT codes out there, most massage therapists will only make use of a handful as part of their billing paperwork procedures. Here are a few examples of billing codes that you might use as part of your massage practice:
- CPT Code 97124 Massage Therapy
- CPT Codes 97110 Therapeutic Exercise
- CPT Code 97112 Neuromuscular Re-education
- CPT Codes 97010 Hot/Cold Packs
- CPT Code 97140 Manual Therapy