Wiki Athletic Trainer Billing as a Physician Extender

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insight

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We are a Osteopathic Clinic that offers Massage, Acupuncture and now Athletic Training.
The AT we just hired is also LMT however her strength is doing exercise therapy and manual therapy. Any tips on how to bill for her services?

Scenario: Patient comes in and is treated by our DO. I bill E/M & OMT for this visit. Patient then goes to see our AT for some exercise instruction. Can I just add 97110 to the DO's claim? Or do I have to do a separate claim for the AT as the rendering?

Thanks!!
 
Athletic Trainer

Per NATA, Athletic Trainers bill with Athletic training evaluation code is 97005 and the re-evaluation code is 97006. Some must be certified also, being ATC.

There is a whole list of FAQs that dip deeper on every topic. Here is the link:
http://www.nata.org/revenue-resources/reimbursement/reimbursement-faqs

Another article on Massage Therapy:

BILLING FOR MASSAGE THERAPY

We have had a recent influx of questions related to the billing of Massage Therapy Services. Generally speaking, massage therapy services, procedure code 97124, is not a covered benefit for personal insurance. It is considered to be an elective services. However, some massage therapy services may be covered by automobile and worker's compensation carriers.

Trigger Point Therapy, procedure code 97140, provided by a properly trained therapist maybe billable if supervised by a licensed chiropractor. In PA, a licensed Chiropractor can supervisor a non-licensed support staff members. The term “supervised” means that the licensed provider is in the facility and available to oversee the services being performed. However, inclusive in Highmark's contractis a stipulation that Highmark will not cover any services provided by any non-licensed staff member. Since massage therapists are currently not licensed in PA, you cannot bill for any services rendered by a massage therapist or by a chiropractic assistant.

So, all of this seems a bit confusing, right. It is. And it is an issue that is highly targeted during insurance post payment reviews. Our best recommendation is that any massage therapy services provided in your office should be provided independent of your practice. The massage therapist should be a tenant, and not an employee of your practice. Massage therapy services for commercial insurance patients should be a cash service, and not billed to commercial insurance. If services are rendered to a auto or worker's compensation patient, we suggest that they be documented and billed by the massage therapist. Not all auto and worker's comp carriers will pay a for massage services, so we recommend that you contact the adjuster to verify if the services will be covered before they are rendered.

http://www.mpms.info/MPMS/blog/?p=70
 
massage Therapy

I realize you're saying "generally speaking". However, massage therapy is covered by most insurance companies when part of a treatment plan. There are variations according to insurance companies and states, but as a whole, massage therapy is a recognized modality, billable. Preverify the coding.
 
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