If you're thinking about billing insurance for massage therapy sessions, you may be wondering, "Where Do I Start?" The answer may depend on your current skills and licensure. As a start to bill insurance, you need to be proficient at SOAP note charting and understand the intricacies of medical massage (for example, knowledge of muscle origins, insertions and actions, Orthopedic Assessment, myofascial release, and neuromuscular therapy).
The four components of a SOAP note are Subjective, Objective, Assessment, and Plan, and it is a method of documentation employed by health care providers to write out notes in a patient's chart. All 50 states currently allow insurance billing for massage sessions involving clients who have been injured at work (workers compensation) and those involved in motor vehicle accidents. You will have to check with your state to see if it is one of the few that allows massage therapists to be contracted providers within the healthcare system. Regardless of your state, it is recommended you obtain your own National Provider Identifier (NPI) number.
You may consider reading a text or taking a CE course to learn the details of insurance billing for massage - forms required, the terminology used, codes accepted, pitfalls to avoid, and other tips. There are several great resources available, including:
- Hands Heal: Communication, Documentation, and Insurance Billing for Manual Therapists, by Diana L. Thompson
- Massage Insurance Billing CE course offered by Vivian Madison-Mahoney
- Business and Professional Skills for Massage Therapists by Sandy Fritz (which includes a trial copy of Massage Office Pro)
Once you begin billing insurance for massage sessions, you should keep a few things in mind:
- Stay up to date on your county/city/state's licensing requirements for massage therapists - you may be required to be nationally certified, have an establishment license, and/or have an Occupational license.
- Always check coverage for services with the client's ins.
- Only bill insurance for Medically Necessary cases. You know a case is Medically Necessary because the client was referred from a physician and has a written prescription for massage.
- Follow the doctor's prescription (frequency/duration of visits and therapy prescribed).
- Document sessions thoroughly and accurately using standard SOAP note procedures.
- Use procedure codes that accurately portray the therapy given and confirm that the insurance company accepts the code before bill submission. The two most common codes used are 97124 (Massage Therapy) and 97140 (Massage Therapy Techniques), but these codes should never be billed together for the same session.
- Use the correct forms and fill them out accurately to avoid payment delays.
Integrating insurance billing into your practice may take some time, money, and effort, but I think that you will find, as I have, that it is well worth it. You will be able to help clients who would otherwise have been unable to afford your services, and you will open the door to greater referrals and increased revenue.