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Wiki Getting insurance to pay for massage therapy
- Thread starter shoy7
- Start date
jojo419
Networker
Billing massage therapy can be tricky and is based on payer rules. For example, some payers will only pay one modality with a visit or two modalities max. Massage therapy is billed in 15 minute increments but I have never seen more than 1/2 hour get paid by health insurance - in my experience. Be sure patient signs an ABN saying they know they might be liable for payment if insurance denies the therapy.
In many cases, HMOs tell their patients that massage is a member benefit which entitles them to say, 25% discount on massage therapy and it does not go through insurance. Patient pays at time of service. I know at least 2 HMOs that have that rule.
So, if you charge $75 for a 50 minute massage, the patient only has to pay out of pocket $56.25....which is cheaper than going to a massage spa.
In many cases, HMOs tell their patients that massage is a member benefit which entitles them to say, 25% discount on massage therapy and it does not go through insurance. Patient pays at time of service. I know at least 2 HMOs that have that rule.
So, if you charge $75 for a 50 minute massage, the patient only has to pay out of pocket $56.25....which is cheaper than going to a massage spa.
cmcgarry
Guest
When I worked for an insurance company we did not pay for massage therapy except to treat lymphedema post-mastectomy. It was an exclusion, and the patient was liable - we did not make it provider liability. However, you should check with each carrier you want to bill - this is one area that they are not universal on.