Understanding the correct CPT codes for your medical practice is essential across all specialties when it comes to insurance billing. Holistic practices, including massage therapists, have unique health insurance billing needs. This includes specific CPT codes for massage therapy. Accurate massage therapy insurance billing is key for reimbursements to be processed faster and with fewer denials and delays.
Looking for a list of the most commonly used massage therapy CPT codes? Look no further! Holistic Billing is an expert when it comes to massage therapy insurance billing. Find the answers to many of the most common questions about the world of massage therapy insurance billing and CPT codes below!
How Do You Bill for Massage Therapy?
Just as with conventional medicine, holistic practices must bill insurance companies to receive reimbursements for their services using CPT codes. These Current Procedural Terminology codes, or CPT codes, are used by insurance providers to document most medical procedures performed by healthcare providers across all specialties. These CPT codes characterize the type of procedure being done so healthcare providers can bill insurance companies for the right services and procedures.
Like other holistic practices, there are unique CPT codes for massage therapy treatments that are specific to the specialty. For a massage therapist to receive quick and reliable payments from the insurance company, insurance coding and billing must be completed accurately. Errors can result in lengthy delays to the reimbursement process - or even denials.
What are Massage Therapy CPT Codes?
The unique CPT codes for massage therapists cover common procedures administered by your holistic practice. It’s important to understand which CPT codes are used for each procedure to risk a disrupted revenue cycle management.
While accepting insurance coverage may make your services more accessible to patients, it also complicates the payment process. It takes time and energy to accurately complete the paperwork involved, especially if you already have a busy schedule in your practice. Understanding the most commonly used massage therapy CPT codes and when to use them can help expedite insurance billing and ensure a streamlined reimbursement process.
Five Essential Therapeutic Massage CPT Codes
Some of the more commonly used therapeutic massage CPT codes are below:
97124 Massage Therapy
Describes the work inherent in massage, which is a separate and distinct service from codes 98940-98943. CPT code 97124 describes work including effleurage, petrissage, and/or tapotement (stroking, compression, percussion) for every 15 minutes.
97140 Manual Therapy
Defined as “hands-on” therapy techniques, consisting of but not limited to connective tissue massage, joint mobilization and manipulation, manual traction, passive range of motion, soft tissue mobilization and manipulation, and therapeutic massage for every 15 minutes.
97112 Neuromuscular Re-Education
Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception in 15-minute intervals. Examples include Proprioceptive Neuromuscular Facilitation (PNF), Feldenkreis, Bobath, BAP’S Boards, and desensitization techniques.
97010 Hot/Cold Packs
Describes the application of moist heat for including, but are not limited to, relaxation of muscle spasticity, induction of local analgesia and general sedation, promotion of vasodilation, and increase in lymph flow to the area. Indications for the application of cryotherapy include, but are not limited to, relaxation of muscle spasticity, induction of local analgesia and general sedation, promotion of vasodilation, and increase of lymph flow to the area.
97110 Therapeutic Exercise
Describes therapeutic exercises applied to a single or multiple body parts to develop strength, endurance, range of motion, and flexibility within 15-minute intervals. Must be applied by a licensed healthcare professional.
Four CPT Coding Tips for Massage Therapy to Boost Revenue in Your Holistic Practice
Use these CPT coding tips to avoid some of the common errors with insurance billing and receive your payments on time.
Avoid Overcoding
Due to the complexity of massage therapy insurance billing, overcoding is a common mistake. It’s important to be aware of the rules associated with each CPT code to avoid delays. For instance, you can only bill either one of codes 97140 or 97124; you will not be able to bill both.
Likewise, CPT code 97010 for hot/cold packs is now mostly “bundled” with codes 97124 or 97140. This means you might not be able to bill a separate fee for this service.
Ensure Your Practice Is Credentialed First
Before you can bill insurance companies for your services, your massage therapy practice should be medically credentialed to bill as an in-network provider or enrolled to bill out-of-network. Credentialing is necessary for many commercial insurance companies, or government plans like Veterans Affairs. Typically, the process involves documentation and verifying all licenses, though the exact requirements vary on the insurance provider.
Confirm Your Patient’s Insurance Eligibility
A common problem with insurance billing is when claims are denied or delayed due to ineligible insurance coverage of established patients. Whether or not the patient declined to alert their healthcare provider about the insurance change or if the provider failed to update patient records, the result can be delayed payments. Confirming your patient’s insurance eligibility before their first visit can prevent issues with insurance companies.
Stay Up To Date With New Codes or Code Changes
Massage therapy CPT code procedures can change through the years or entirely new ones can be created. Since codes can be revised and discarded, your holistic practice needs to stay aware of the most current information and make sure you’re not using any outdated codes that could cause issues with insurance billing.
Balancing your practice’s insurance enrollments, billing, and coding while delivering care to your patients can be overwhelming, but outsourcing your massage therapy insurance billing can save you time, energy, and streamline your revenue cycle management!
As an experienced billing provider for holistic practices, Holistic Billing Services can help your practice navigate the insurance billing process to minimize denials and increase revenue. With a knowledgeable partner by your side, you can focus more on treating patients to help your practice grow rather than worrying about insurance billing. To learn more about our massage therapy billing services, talk to one of our billing and coding experts today.
