Can I Bill Insurance For Massage Services

Is Massage Therapy Covered past Insurance?

Learn most massage therapy insurance coverage and CPT codes. Detect out how to get massage therapy covered by insurance through diagnosis.

What is Medical Massage Therapy?

Medical massage therapy is different than general massage therapy because it focuses specifically on healing injuries, improving part, increasing circulation, etc. Medical massage therapy treatment is planned out with a specific goal in listen, with each massage factoring into a larger treatment plan that is based around the wellness needs and goals of a client.

Once traditionally seen as a spa handling, massage therapy has apace go an established and reputable method of healthcare. Massage therapy is now considered a part of the complementary and alternative field of medicine and is often used to drag standard treatment by physicians when working with clients with specific conditions and ailments. The latest CDC information shows that 23.5% of adults have had at least one expenditure for a CAM care arroyo.

As more wellness providers recommend massage therapy services as a compliment to their treatment plants, clients are seeking benefits from their insurance providers to help cover the costs. Receiving reimbursement by insurance payers takes intendance and communication, both with your clients and the insurance company.

In this article, we help Massage Therapists better navigate insurance reimbursement. Larn how you can help clients better utilize massage therapy covered by insurance through Healthie'due south practice management platform. To larn more about our complimentary starter plan click here!.

Verifying Insurance Coverage & Reimbursement for Massage Therapy

At the current time, at that place is no standard massage therapy insurance coverage for services within big insurance providers. This means getting coverage comes down to the reason for care and how that care is defined to the insurance visitor. 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 y'all volition be reimbursed. Additionally, if the services fit into the category of "habilitative or habilitation treatment," it may exist considered an essential health benefit and your client will receive coverage. Many insurance companies deem massage therapy necessary in the acute stage of treatment, rather than as a long term care procedure.

Why Doesn't Insurance Always Cover Massage Therapy?

Unfortunately, massage therapy is withal considered an alternative treatment, and insurance companies ofttimes won't cover these types of treatment outright. Thankfully, there are a few methods by which you can attempt to attain massage therapy insurance coverage for clients.

An like shooting fish in a barrel 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 doc is important for reimbursement because massage therapists are not licensed to diagnose medical weather. With a referral from a dr., the massage therapist can include the ICD-10 diagnostic lawmaking and referring provider on their CMS-1500 form, and increase their chances of reimbursement.

1 potential barrier to coverage is provider credentialing. A recent report involving health insurance policies nationwide showed that being credentialed as a massage therapist was non always enough to qualify for reimbursement; sure companies required providers to receive pre-authorization prior to providing services.

Massage therapy insurance reimbursement can also vary from country to country. All 50 states offer reimbursement for clients who are injured while at work or in a motor vehicle incident. Some states will provide reimbursement for services prescribed by a doctor; it'south important to be consistently checking the legislation inside your state to ensure you are upwardly to date on what is currently covered.

The best way to ensure massage therapy insurance coverage is to verify your client's benefits with their insurance provider earlier providing whatsoever services. When verifying their benefits, be sure to ask questions that will go you the clearest understanding of your customer's coverage, such equally:

What are the atmospheric condition to qualify for reimbursement?
Will there exist a deductible or whatever out-of-payment toll? (And so you can alarm clients alee of time)
Is there a maximum amount payable per visit or per policy term?
Am I express to treating any specific torso region?
Practise all types of massage therapy qualify for coverage?

CPT Codes for Massage Therapy Codes

Once yous've verified that massage therapy coverage is possible, the ii main billing CPT codes identified for insurance billing of massage therapy include:

97124: Stroking, compression, percussion
97140: Manipulation, traction, lymphatic drainage

What is the Difference Between 97140 and 97124?

Code 97124 is more so directed at massage therapy, while 97140 is actually for manual therapy. When billing for either of these two massage therapy codes, be certain to cite these verbal treatment procedures in your claim to ensure coverage.

Can CPT Code 97124 and 97140 Exist Billed Together?

You can not cite both of these codes when submitting for reimbursement. Insurance companies will not encompass services if both of these codes are cited.

Be sure to also have your customer'south insurance information & photocopies of their card on file, as well as their chart notes for each session readily available. These will exist essential when filling out your CMS-1500 forms for each reimbursement. If your exercise is struggling to navigate this system, make tracking all of these codes simpler with Healthie. Healthie reduces the administrative time of corporate wellness professionals past over forty%, and enables real-time communication within an organization and with clients.

What to do If Services Are Non Covered

If yous are unable to guarantee massage therapy insurance coverage or reimbursement from your client's insurance company for services, you can use a variety of other payment techniques that may be enticing to clients.

✨ Accept an HSA/FSA Bill of fare

Flex Spending Accounts (FSA) and Health Savings Accounts (HSA) are commonly used bank accounts that employees can set up upward through an employer to gear up aside pre-tax money to pay for qualified medical expenses.

By accepting FSA and HSA cards for massage therapy services, you'll enable your clients to use pre-revenue enhancement dollars, that they accept already set aside for healthcare expenses, to piece of work with yous. You will still get paid for your services, only you lot and your clients can avoid the stress of dealing with insurance companies or having to pay fully out-of-pocket.

✨ Include services in a package at a discounted charge per unit

While this selection withal requires a client to pay out-of-pocket for your services, including massage therapy within a packet at a discounted charge per unit can assistance clients who need your services, but are struggling to pay. For case, if you charge $100 per session, yous can offer a package of five sessions for $425, to make services more than accessible to your clients defective coverage.

This is also a great strategy for keeping your calendar total and ensuring consequent client appointments. With a parcel, clients are more probable to follow-up sessions, and use all of their credits. They won't disappear after one or two appointments.

✨ Offer a Superbill

If clients are willing to pay out-of-pocket rates for your services, yous tin generate a Superbill for them to endeavor and get massage therapy coverage from their insurance companies. Superbills are a receipt of your services that clients can submit to their insurance companies in hopes of being reimbursed for their payment. They do not guarantee reimbursement, but they take very piffling time for you lot as the provider to put together and may result in a client getting some or all of their payment returned to them by the insurance visitor. Healthie's new free Starter plan can handle all of your superbill needs, sign upwardly for a free account today.

✨ Chapter with an insurance company

In lieu of offering coverage for massage therapy services, some insurance companies let massage therapists to "chapter," with them. This means that, while clients will not get coverage for their services, insurance companies will give them discounted rates for services at certain massage therapy practices. Massage therapists volition not be reimbursed by the insurance visitor, but instead do good from an increased stream of recommendations to clients by the insurance company.

Healthie for Massage Therapists

Healthie's all-in-one software helps massage therapists streamline scheduling, billing, note-keeping, and client advice. With features such as:

✔️ Insurance billing: Generate CMS-1500 claims that can be batch-downloaded and submitted to your clearinghouse of choice. Hands track claim statuses and reimbursement within Healthie, or invoice clients for non-covered amounts.

✔️ EHR: Leverage Healthie's HIPAA-compliant electronic health record allows yous to proceed clients' personal health information secure, and track client progress using custom-congenital chart notes.

✔️ Packages and Invoices: Create custom package offerings and authorize client payments using our integration with Stripe. Generate invoices and receipts for payments.

✔️ Online Booking: Healthie'southward scheduling characteristic allows you to create custom appointment types, set availability, and book online via our web platform or mobile app.

✔️ Client Date: Check in with clients betwixt appointments using Healthie's HIPAA-compliant chat feature.

Healthie allows you lot to focus on your clients while knowing your back-office responsibilities are handled.

Learn more than about Healthie for massage therapists here.