One of the quickest ways to ensure your healthcare revenue cycle is running smoothly is to utilize the most current medical billing codes for your practice. If you code for the wrong treatment, over or under code for services rendered, or submit your claims late, then you run the risk of delayed payment and a host of other issues.
If your holistic practice offers massage therapy treatments, then you’ll want to keep this list of massage therapy CPT codes and tips handy! Be sure to bookmark this page for easy reference so that you can enjoy a streamlined medical billing process.
Essential Massage Therapy CPT Codes
Some of the most commonly used CPT codes used by massage therapists are below:
- 97124 (Massage therapy): Describes work including effleurage, petrissage, and/or tapotement (stroking, compression, percussion) for every 15 minutes
- 97140 (Manual therapy): Includes 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): Entails the re-education of movement, balance, coordination, kinesthetic sense, posture, and proprioception in 15-minute intervals; examples include PNF (proprioceptive neuromuscular facilitation), Feldenkreis, Bobath, BAP’s Boards, and de-sensitization methods
- 97010 (Hot/cold packs): describes the application of moist heat or cryotherapy for relaxing muscle spasticity, promotion of vasodilation, increasing lymph flow, or other situations
- 97110 (Therapeutic exercise): use this code for therapeutic exercises applied to a single or multiple body parts to develop strength, endurance, range of motion, and flexibility within 15-minute intervals
Essential Modifiers for Massage Therapy CPT Codes
Sometimes it’s not enough to use the baseline massage therapy CPT codes – in which case, you’ll likely need to refer to these code modifiers:
- Modifier 59: This modifier for massage therapy CPT codes indicates that two separate but similar procedures were performed on the client within the same day or time span of a few days
- Modifier 52: Use this modifier if billing for a procedure that used a reduced modality as the provider saw fit
Billing Medicare: Timed vs. Untimed Massage Therapy CPT Codes
If your practice accepts patients who are covered by Medicare, then you’ll need to be mindful of the difference between billing for time or untimed massage therapy services.
Billing Medicare for Untimed Massage Therapy
When you choose to bill for untimed massage therapy services, you can only bill for one whole service. This means that no matter how much time you spend with your client, you’re only billing for one treatment as a whole.
Billing Medicare for Timed Massage Therapy Treatment
On the other hand, if you’re billing Medicare for a timed massage therapy treatment, then you get reimbursed based on the time spent 1:1 with the patient providing treatment. These timed codes can be billed multiple times per session.
Each code equates to 15 minutes of treatment; however, if the time spent with your client doesn’t result in an even amount of time divisible by 15, then you’ll use the 8-minute rule. Basically, after dividing the time of the session by 15, if the remainder you have is greater than 8 then you can round up and bill for an additional unit. If the remainder is 7 or less, then you’ll bill for the minimum number of units.
Here’s a handy table for referencing the 8-Minute Rule:
- 8-22 minutes: 1 Unit
- 23-37 minutes: 2 Units
- 38-52 minutes: 3 Units
- 53-67 minutes: 4 Units
Medical Billing Tips for Your Massage Therapy Practice
Keeping your healthcare revenue cycle in good health is no small feat; check out these tips for medical billing success:
First, Ensure Your Practice Is Appropriately Credentialed
Before you can bill insurance companies or government programs for your massage therapy services, your 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 differ from provider to provider.
Confirm Your Patient’s Insurance Eligibility Ahead of Time
A frequent problem when going through the medical billing process is when claims are denied or need to be reworked as a result of ineligible patient coverage information. Whether the patient is wholly ineligible for the services rendered or their information changed without being updated, this can result in delayed payments and the need to rework the claim. Be sure to confirm your patient’s information every time they come into your practice!
Be Careful to 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 all the massage therapy CPT codes to avoid delays.
For instance, you can only bill either one of codes 97140 or 97124; you won’t be able to bill for 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.
Balancing your practice’s online appointments, SOAP notes, 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 optimize your revenue cycle management!
As an experienced EMR and insurance 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.
