Eli's Rehab Report
Check Licensing Regs Before You Bill 97124
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Question: Third-party payers have been denying my claims for CPT 97124 . The reason for denial is that a licensed massage therapist must perform the service, but there is no licensing for massage therapists in my state. How can I get paid for this?
Michigan Subscriber
Answer: Some insurers will only reimburse massage (97124, Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement [stroking, compression, percussion]) when a licensed provider performs the service.
If a carrier tells a massage therapist that certification is required for reimbursement but the state offers no certification or licensing, the massage therapist may consider certification through the National Certification Board for Therapeutic Massage and Body Work.
You should contact your state medical board and request a letter stating that massage therapy is a legal part of your practice.
Forwarding this letter to third-party payers may help to improve your reimbursement odds for massage therapy.
Keep in mind: If a licensed massage therapist performs the massage therapy, you must also determine whether it is part of the therapy plan of care and, if so, whether that specific payer allows massage therapists to provide services under the supervision of the PT.
Remember also to check your state practice act regarding the use of aides and, if allowed, what services they can perform and under what type of supervision.
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