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Massage Insurance Billing


Massage Insurance Billing

All about billing insurance companies for massage services. What states can you bill for mva's, work injuries, PPO's, HMO's? What is required in each state or even city?

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Latest Activity: Jul 16, 2017

Massage Insurance Billing

I have been billing insurance since the beginning of my career which started in 1989. I am not an expert but do know a fair amount about it. The thing is that there are so many differences in each state and in each city and even each insurance plan it can be overwhelming. I have used insurance billing through my career to keep it stable. Yes there are difficulties in getting paid but I found that the more I knew the better I was able to weed out problem cases and set boundaries around working with people and their insurance companies. I am starting this group to allow people to share their insurance billing tips, classes and information.

Please start a discussion topic and use your state/city in the heading and share information on what massage insurance billing you are able to do in your area.  Thanks Julie

Discussion Forum

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ICD-9 code: is it needed? 1 Reply

My thought is that we do as LMT's need an ICD-9 code from a referring physician in order to bill for massage therapy.  Is this correct?  I recently received a script from a physician referring his…Continue

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Hiring a Medical Biller 6 Replies

I am looking to "hire" a medical biller to bill insurance for my practice. I am a one man show…Continue

Started by Trina Throckmorton. Last reply by erica ragusa Oct 1, 2014.

What states/cities, insurance plans can you bill in your state? 9 Replies

One of the most common questions I get is what insurance company can I bill?In Most states you can bill for car accidents and work related injuries but there are certain rules in some states like…Continue

Started by Julie Onofrio. Last reply by Julie Onofrio Apr 11, 2012.

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Comment by Jan Seeley, LMP on March 13, 2010 at 12:45pm
Kimberly. Washington State is a forerunner in allowing/mandating that health insurance pay for massage, and it is by prescription/referral only. The rx has to spell out what the diagnosis is, including diagnosis code, and how many visits over what amount of time.. Massage therapists cannot, by law, diagnose, and you have to have that in order to bill. All states are different, so you'd have to check with WI massage laws, etc. to find that out. Here we are licensed as healthcare practitioners, just like a doc, chiro, etc. Not all states do that.
Comment by Kimberly Rogers on March 13, 2010 at 11:46am
No problem. Is it even possible for MTs to bill insurance in WI? My husband's company (when he is not serving in the National Guard) has started offering health savings accounts...but even there, massage therapy is listed as reimbursable only as prescribed by a medical physician.
Comment by Jan Seeley, LMP on March 12, 2010 at 2:42am
ahhh...I understand. It's a Wisconsin thing...based out of Eau Claire, for Medicare/Medicaid patients who are trying to stay in their own homes despite being incapacitated. Interesting services...operates as an HMO and a Managed Care Operation...thanks.
Comment by Kimberly Rogers on March 12, 2010 at 1:48am
Sure. My colleague was trained and licensed by WI as a nail technician. She studied reflexology later, after she established her business. She has been caring for clients for over 10 years. And two years ago, became nationally certified in Reflexology through the American Reflexology Certification Board (ARCB). She was approached by a group named Community Health Partnership (CHP) and asked if she would be willing to work with low-income clients.

I worked out of her office as a massage therapist for a short time. She is located in northwestern WI. If it weren't such a long drive for me, I probably would still be there. I only worked out of her office a couple of days a month, so I'm not sure how it was all set up. She also was talking to other insurance companies. Unfortunately, I don't have much more information. Whenever I asked how she set everything up, I couldn't get a straight answer.
Comment by Jan Seeley, LMP on March 11, 2010 at 7:56pm
your colleague who billed for reflexology and "nail care" she a massage therapist? Nail care isn't exactly a billable thing for massage therapists. And, at least in this state, reflexology, I think, is iffy as far as insurance billing is concerned. Can you explain a little, Kimberly?
Comment by Kimberly Rogers on March 11, 2010 at 5:31pm
Hi. I look forward to learning more about insurance billing. I have always been against it in the past, but a colleague of mine was able to bill insurance for reflexology and nail care out of her clinic. Because she did this, she was able to keep her doors open during the economy crunch. I am interested in learning more. I live in WI, and have no idea what to do first. I hope to learn a lot from everyone on this forum. Thanks for creating this group!
Comment by Vivian Madison Mahoney on February 8, 2010 at 11:48pm
Ok all, let's calm down. I will clarify, I said they could make about $200.00 on the first patient session. How many of you know that you just might be able to bill for an initial evaluation, if done properly?

No, all insurers do not pay for this. How many know that the average initial evaluation (for insurers that will pay it) is about $120.00 for a massage therapist? And as someone mentioned, the $120.00 is about the average a massage therapists gets reimbursed for a one hour session in some cases.

I know there are those who, as Nancy said, who overcharge up the gazoo, but that is why I am able to help the defense attorneys and fraud divisions for some insurance companies who call on me for consultations and testimony on a nationwide basis. I am considered an "expert witness" for those in the industry who are trying to weed out the frauds and those who take advantage of insurance companies and ultimately the patients.

This is NOT meant to sound egotistical . That is not me. It is so very difficult to be one person trying to reach the multitude of therapists who need, want and deserve the truth about insurance billing.

I have had 20 years of training massage therapists across the nation and have loved every minute of helping others to build their businesses to successful levels, getting emails and phone calls of praise has been as rewarding as someone telling me what a great massage I gave them. And I know you all know how that feels, don't you?

As I always say, I cannot be expected to teach a seminar in this or any short message.

I just hope that you can trust me because I have billed insurance since 1984 and very successfully with over 172 physicians referring from all specialities, with over $500,000 in yearly income and on and on.

Some insurance cases are better at reimbursing than others. All states so far have some insurance companies that have been reimbursing massage therapists when one knows what and how to bill. There is no state that I cannot tell you something about because I keep up on all of them. However some states change rules, some states are better than others and I have key contacts in some states like Diana Thompson in WA who has been willing to share her knowledge as she did in the seminar I just presented in OR. in Oct.

By the way, an LMT who first took my class in TN took it over again in OR just to share with the class how she was so excited that from the TN class and materials she was able, in less than 2 years, to build her business in WA to having 12 therapists working for her and all with insurance cases!!

The Kentucky Board of Massage has honored me with their confidence by requesting that I be their presenter for the 12 CE's on insurance billing, taxes and marketing that they are offering to all their KY State Licensed LMT's. Although I have presented 2 times in KY I never present again without research to get all the updated state specific information to be sure I am not misleading anyone on any subject regarding insurance, in any state.

I work hard and daily to keep up on all aspects of health care, health care reform and insurance in all states. I know for instance that Ohio Workers' Compensation pays $35.80 per unit (fifteen minutes) for manual therapy. I also know that FL pays only $19.00 per unit for massage therapy 97124.

I know that in MN a massage therapist was refused the manual therapy code because she was not a PT, I helped her win her case as in many cases across the nation. This is because I know the ropes. I have suffered the mistakes and errors and time consumed in the learning process. I have worked hard to make it easy for all others, because I do not want to ever see anyone have to go through what I went through to learn because NO Massage Therapist billed insurance when I started. But while I am willing to go the extra mile to help, I cannot be expected to give all the information away for free. One has to invest in their future and I happen to have the materials that can make it happen for those willing to invest.

I have seen soooo many LMT's trying to take the short cuts, they get a code, a form or some information from a massage therapist who 'heard it from the grapevine" or who had never billed themselves and then think they can bill insurance for a living. There are legalities, rules, laws, guidelines, codes that can and cannot be used, there are types of insurance cases we can and cannot accept and so on. To know all of this is like having a boat to cross the river. Ok, I am here to help you steer the boat but you have to purchase that boat first, if you know what I mean.

As always, if I can help call or email me:
865-436-3573 or if you are wanting to jump on the bandwagon with me for changes in health care where we see discrimination taking place, please send an email to and in subject line, simply type: I'M IN.

By discrimination I am talking about the insurance companies who say, "we pay for massage but we only pay a PT. MD or DC but not a massage therapist." We have to put a stop to this!!
Comment by Ann Ross on February 8, 2010 at 10:10pm
No problem, Jan. There is always more to learn when it comes to billing insurance. I only know what I know :) I'm sure Vivian can help clarify. She is the queen of massage insurance billing :)
Comment by Jan Seeley, LMP on February 8, 2010 at 10:03pm
To Ann Ross. I've never known anyone legitimately getting that either. To quote Vivian Mahoney "If my making a living selling a manual to a massage therapist for $109.90 including S&H is too expensive to help them make over twice that amount in the VERY FIRST PATIENT SESSION if and when properly billed, then tell what I should be doing from here on out?" So I guess I should have directed my question to her, huh...
Comment by Darcy Neibaur on February 8, 2010 at 5:33pm
In the state of Florida, an LMT billed my insurance company and was paid $5000.00 on a pip claim for sessions he did not do. Just for the record the attorney was contacted and the LMT lost his job as well as the secretary who was forging prescriptions for him. He was billing my insurance company $50 for each unit which is 15 minutes and was paid that amount. He made more than the Chiropractor.

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