Massage is a strong tool that may assist in rehabilitation and overall wellbeing for those who are suffering from acute injury, chronic pain, high levels of anxiety and stress, or any combination of these conditions. You already have a good understanding of this since you work as a massage therapist. You see people come in with a broad array of problems, ranging from trauma-related injuries to back spasm, and you use the power of massage to help them get functional once again.
As a person who practices massage, you should strive to make your services available to the greatest number of customers at all times. But there are many other ways to go about increasing your capacity to assist a wider variety of customers. You might, on the one hand, concentrate on continuing education for massage therapists. You will be able to provide a broader range of services to your customers if you educate yourself on specialized methods such as sports massage and deep tissue massage. This, in turn, will allow you to attend to a higher number of customers during the course of the day. As a side note, it is essential to make sure that your massage continuing education units come from a source that is authorized by the NCBTMB in order to guarantee that they will be accepted by the massage therapy licensing board in your state.
The expansion of the scope of your profession may be thought of in this sense as well. On the other hand, if you want to see a greater number of customers, there is another strategy you may use. Instead of requiring all of your therapy clients to pay for massage services rendered out of pocket, you may want to think about giving clients the choice of billing the health insurance provider for cost reimbursement.
It is possible to submit claims to health insurance companies for massage therapy in a number of states in the United States. Talk to the insurance billing staff at any medical office and they will tell you just how complicated the process can actually be. There are billing codes, diagnostic codes, record keeping, forms, and paperwork, in addition to a variety of other items to take into consideration.
Despite this, it is feasible to bill insurance for massage in some regions of the U.S, and doing so can make a great deal of sense for your business. As a result, we have compiled this guide in order to respond to some of the most often asked issues about the process of insurance billing for massage therapists.
Things to Consider Insurance Billing for Massage Therapists
The process of insurance billing for massage therapists is not an easy one, as you have probably already deduced from what was said above. It is not something you can just decide to do and then instantly include into your massage practice. To do so will involve a considerable amount of planning, as well as a large level of follow-through to really execute on the back end of things.
It is essential that you give some thought to the primary motivation for your participation in insurance billing for massage therapists.
Are you merely trying to increase the amount of money you make from your customers? Some massage therapists want to be able to bill insurance since they feel it would boost their level of revenue while at the same time bringing in more customers. This could make sense in certain areas of clinical practice. Being able to bill insurance might make a lot of sense, particularly if you want to specialize in things like the treatment of post-accident concerns or others.
There is no denying that the idea of being able to expand both the number of patients you serve and the amount of money you make seems like a beneficial thing to do. However, there are a number of possible concerns that need to be taken into consideration.
To begin, it is essential to have a solid understanding of the fact that in order for a customer to actually obtain payment from their insurance company for massage therapy, a primary care physician will often need to sign a prescription for the service. It is not possible for a customer to come in on their own initiative for a massage and then afterwards submit a claim for payment to an insurance company. Instead, they will often be required to get both a prescription and pre-authorization to get treatment from their insurance provider in order to receive treatment. Explaining this to patients and giving them the required help as they negotiate these sometimes confusing stages may generate a significant amount of additional work for your massage therapy practice.
When you take into account the paperwork that is required on top of this, you might discover that the supposed increase in your revenue as a result of increased client traffic is counterbalanced or outweighed by the additional stress, aggravation, and paperwork that is required. This is because the paperwork that is required on top of this must be completed. A massage therapist who works in a larger integrative health clinic may be allowed to delegate some paperwork tasks to the office’s claims and billing department.
Each U.S State Might Have a Different Requirement for Massage Billing
Even if you come to the conclusion that submitting claims for insurance reimbursement is the best course of action given the circumstances of your case, there are other things to consider. When it comes to massage treatment and medical insurance, every state has its own regulations and requirements.
In many places, the way in which you are classified as a massage practitioner is one of the most important criteria in defining your legal standing. There are certain states that recognize massage therapists as “health care practitioners,” or HCPs for short. One of these states is Washington state, which is an example of a state that has extremely defined rules for what a massage therapist must perform in order to acquire a license and be deemed a health care provider (HCP).
It is possible that you will not be allowed to charge customers’ insurance companies for the services you perform if the state in which you work does not recognize massage therapists as health care practitioners. You should get in touch with the licensing board for your state, as they will be able to provide you more specific information on the process.
Massage Therapy and CPT Codes
Assuming that you have made the decision to include insurance billing in your massage practice and that you have determined that you are eligible for it in your state, the next step in the process is to gain a better understanding of the paperwork and particularities involved in the billing process.
You will need to become acquainted with something called a CPT code, which stands for a Current Procedural Terminology code. This is one component of the accompanying paperwork that you will be responsible for. CPT codes, or Current Procedural Terminology codes, are used as a nationwide standard for the codification of various medical procedures. The American Medical Association (AMA) is in charge of maintaining the coding system.
Even though there are a huge number of CPT codes available, the vast majority of massage therapists will only utilize a few of them when it comes to the billing paperwork that must be completed.
The Bottom Line
Independent massage therapists and the organizations that employ them are left to deal with something that is not as rosy as the growing dependence on massage therapy and the increase in the number of therapists. This includes partial insurance coverage and disparity in the regulations that govern massage therapy from one state in the United States to the next. The requirement that a treatment must be approved by a physician in the form of a prescription and that it must be carried out under the supervision of the physician is one of the factors that contributes to the complexity of the regulatory framework.
Billing and coding specialists have spent years honing their skills and are equipped with extensive knowledge in the billing and code processes related to massage therapy. Because of their high level of expertise, they are able to determine which treatments are acceptable for payment by massage therapy insurance, and then they can file claims by making appropriate use of the administrative and medical information that is required. If you are a healthcare practitioner or the owner of a medical facility and want to know more about medical billing, do write to us with any of the questions that you might have in your mind and we would love to guide you in the best possible manner.