Massage Insurance Billing : Becoming a Contracted Provider
How can we get Health Insurance Companies to pay for
massage therapy?
There is much controversy over the topic of medical
massage, it's meaning and what it will allow us to do. At the time there
is no clearly defined medical massage therapist. As a profession, we have
not been able to define it.
But what is happening right now in WA State with a company
called Group Health who's massage providers are overseen by another company is creating a definition and
certification for us! What that means is that we don't have a say in it
any more!!
Here in WA we are able to become contracted providers with
insurance companies such as Blue Cross, Blue Shield, Aetna and others.
What happened was the insurance commissioners office
enacted a law called the "Every Category Law" that made it mandatory
that every insurance company allow massage therapists and other alternative
therapists to become contracted providers with such companies.
The insurance companies held it up in courts protesting it
until the Supreme court over-ruled their protests and enacted the law.
At the present we can bill insurance companies and become
contracted health care providers, but it is
at a cost. We are not paid our hourly rates. (Most pay less than $70 which
is the going rate in the Seattle area). Payments are delayed.
Sessions are dictated by the insurance companies whims and they are always
trying to find some way not to pay us. The policy limits are constantly
being reduced. What were once nice benefits that covered massage in full
and as needed are reduced to 10 sessions a year combined with physical therapy
benefits. We all know if someone has a back problem, that 10 sessions may
not resolve the issue.
So, if you still are interested in becoming a contracted
provider with a major medical insurance company, I would recommend contacting
your insurance commissioners office. You should also get your local
massage therapists together, along with any associations in your area and start
defining your profession. The ability to bill certain CPT codes really
depends on how we are defined as a profession.
I also recommend holding out for allowable fees that will
let you make a decent living and not have to work more just to be able to make
ends meet because you are forced into accepting lower payments for your
services.
