Billing Codes for Massage Therapists
CPT (Current Procedural Terminology) codes for massage therapy and related procedures - identifies the type of care or the procedure that is used in that care. The best way to know what codes the insurance company will accept is to call and ask them! You can not just bill whatever code that they accept. You have to bill what ever code you are trained in. Setting your fees for these codes are another issue. Just because you can get paid more for certain codes, you have to charge the same amount you charge cash clients (plus whatever additional billing fee there is) or else it is considered insurance fraud.
97010- modality; hot or cold packs- 15 minute increment
97124- massage treatment-15 minute increment
97140- myofascial release, manual therapy- 15 minute increment
97112- neuromuscular re-education- 15 minute increment
Diagnosis codes (ICD codes-International Classification of Disease)- Diagnosis codes are often needed when billing even though we are not able to diagnose. This information should come from the referring physician. If the physician does not write the code on the prescription, call them directly to get the code. I highly recommend that you do not try to select your own code from the online code finder or the information below as each physician may code things differently. I am providing this information because physicians often write the code but they don't say what it means.
Call the Physician to get the correct code.
Thursday, September 23, 2010
Medicare physician fee schedule - Quick overview
Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:
* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.
Medicare Physician Fee Schedule Payment Rates
Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)
Medicare Physician Fee Schedule Payment Rates Formula
The Medicare PFS payment rates formula is shown below:
[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF
Medicare fee schedule download
covered services and their payment rates. Physicians’ services include the following:
* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.
Medicare Physician Fee Schedule Payment Rates
Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)
Medicare Physician Fee Schedule Payment Rates Formula
The Medicare PFS payment rates formula is shown below:
[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF
Medicare fee schedule download

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