Wiki Massage Therapy and Medicare

snodine

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I have had this question posed. If a Massage Therapist does code 97110,97112, 97124 or 97140 can they be billed under the physician in the practice? And will Medicare or other payers pay for it? I'm uncertain if he MT can bill for anything but 97124 and maybe 97140. Any advice is appreciated.
Thanks,
Susan
 
Massage Therapy and medicare

A Licensed Massage Therapist can bill those codes under the Physician they are supervised under; Medicare does not pay for those codes, but private payers, WC, and MVA may, depending on the patient's policy. For private payers, you must call the insurance company and find out if they cover massage as performed by a Licensed massage therapist, or if they cover it if done by the LMT but supervised by a Physician. They may cover under both scenarios. (If by "physician" you mean "chiropractor", the LMT may have to be a Certified or Licensed Chiropractic Assistant in order for the codes to be paid - again, call the insurance company and find out). You may need a referral or prescription from the Physician in order to be paid.

For WC and MVA, depending on the laws of your State, the codes you mentioned should be covered if performed by a Licensed Massage Therapist if the patient has a written prescription for the massage from a Physician. The written prescription should be sent to the ins. co with each bill. The LMT does not necessarily have to be supervised by a Physician in the case of MVA/WC, but even if they are, the insurance should pay for it, again, with the prescription.

The LMT can bill for 97110 and 97112, but the documentation needs to be very specific as to what they are doing to justify these codes. I used to bill for a Chiropractor and many private payers did not understand what neuromuscular re-education (97112) was - we had to send a letter explaining what it was and where/what in the doctor's note described/showed that therapy was being done.

I hope this helps. Good luck!
Lisa
 
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