Wiki Billing for Massage Tharapist

[SBrant]

Is anyone able to point me to some documentation on the Texas regs in reference to billing for a massage therapist? I have a provider billing carriers for massage therapy under their own credentials when they are not the one performing the services. (A message therapist is performing services and their name is going nowhere on the claim) The provider is not even in the office for some of the encounters. The provider assures me they have researched and there is no problem with billing this way. This does not sound like an acceptable practice to me but Google and I cannot find confirmation or otherwise.

 

[mitchellde]

Is anyone able to point me to some documentation on the Texas regs in reference to billing for a massage therapist? I have a provider billing carriers for massage therapy under their own credentials when they are not the one performing the services. (A message therapist is performing services and their name is going nowhere on the claim) The provider is not even in the office for some of the encounters. The provider assures me they have researched and there is no problem with billing this way. This does not sound like an acceptable practice to me but Google and I cannot find confirmation or otherwise.

Anytime you bill under a provider that did not perform the service you are filing an incident-to claim. Unless you have specific guidelines from a carrier on writing as to their own incident-to rules you should assume they follow Medicare. This means the therapist must be an employee of your physician and the visit has been prescribed at a previous encounter via a plan of care written in the chart note, and the provider must be on the office suite area at the time of the encounter. So the points are
- employee of the provider
- established patient
- written plan of care from previous physician encounter to include this service
- physician in the office suite area at the time of the encounter
If all of the points are not met then the visit must be billed under the therapist NPI

 

[jessica.beaty@dhcmak.com]

I have the same questions! Our MD's are wanting us to bill the same way as the original poster said.
I have looked all over the web for billing guidelines for massage therapists and cant find anything.
I will research the incident-to claims.

Thank you!