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Please also check the
insurance billing manual updates and the
blog for more information.
Massage Insurance Billing : Becoming a Contracted ProviderHow 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.
Please also check the
insurance billing manual updates and the
blog for more information.
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