CPT stands for Current Procedural Terminology (CPT). The American Medical Association (AMA) oversees the codes that define and structure the procedures and services provided by physicians and other health care providers across the country.

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. Keep in mind that these codes are updated periodically. Staying up to date with new codes can help facilitate claims processing and reimbursement.

If you are looking for the most commonly used CPT codes for massage therapy practices. Find the answers to your queries about massage therapy CPT codes with medical billing codings.

How to Bill for Massage Therapy?

Just like conventional medicine, holistic practices must bill insurance companies to receive reimbursements for their services using CPT codes. These CPT codes, are used by insurance providers to document the majority of medical procedures performed by healthcare providers across all specialties. These CPT codes identify the type of procedure being performed, allowing healthcare providers to bill insurance companies for the appropriate services and procedures.

Massage therapy treatments have their own CPT codes that are specific to the specialty. Insurance coding and billing must be completed correctly in order for a massage therapist to receive prompt and consistent payments from the insurance company. Errors can cause lengthy delays in the reimbursement process, as well as denials.

What are CPT Codes for Massage Therapy?

Massage therapists' unique CPT codes cover common procedures administered by holistic practise. To avoid disrupted revenue cycle management, it is critical to understand which CPT codes are used for each procedure.

Understanding the most commonly used massage therapy CPT codes, as well as when to use them, can help speed up insurance billing and ensure a smooth reimbursement process.

Five CPT Codes for Massage Therapy

Some of the more commonly used CPT codes used by massage therapists are below: 

97124 Massage Therapy

CPT code 97124 Describes the work inherent in massage which includes effleurage, petrissage, and/or tapotement (stroking, compression, percussion) for every 15 minutes. 

97140 Manual Therapy

Described as "hands-on" therapy methods, which may include but are not limited to connective tissue massage, joint mobilisation and manipulation, manual traction, passive range of motion, soft tissue mobilisation and manipulation, and therapeutic massage every 15 minutes.

97112 Neuromuscular Re-Education

In 15-minute intervals, neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception. Examples include Proprioceptive Neuromuscular Facilitation (PNF), Feldenkrais, Bobath, BAP's Boards, and desensitisation techniques.

97010 Hot/Cold Packs

Describes the use of moist heat for a variety of purposes, including, but not limited to, muscle spasticity relaxation, induction of local analgesia and general sedation, vasodilation promotion, and increased lymph flow to the area.

97110 Therapeutic Exercise

Describes therapeutic exercises performed on a single or multiple body parts in 15-minute intervals to improve strength, endurance, range of motion, and flexibility. 

Four CPT Coding Tips for Massage Therapy to Boost Revenue

With the help of below given coding tips one can avoid some of the common errors with insurance billing and receive your payments on time. 

  • Avoid Overcoding

Overcoding is a common mistake due to the complexity of massage therapy insurance billing. To avoid delays, it is critical to understand the rules associated with each CPT code. For example, you can only bill one of the codes 97140 or 97124; you cannot bill both.

Similarly, 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

Many commercial insurance companies and government plans, such as Veterans Affairs, require credentialing. The process usually involves documentation and verification of all licences, though the exact requirements vary depending on the insurance provider. Your massage therapy practise must be medically credentialed to bill as an in-network provider or enrolled to bill out-of-network before you can bill insurance companies for your services.

  • Confirm Your Patient’s Insurance Eligibility

When claims are denied or delayed due to established patients' ineligible insurance coverage, this is a common problem with insurance billing. Whether the patient failed to notify their healthcare provider of the insurance change or the provider failed to update patient records, the result could be delayed payments. Confirming your patient's insurance eligibility prior to their first visit can help you avoid problems with insurance companies.

  • Stay Up to Date with New Codes or Code Changes

Massage therapy CPT codes can change over time, or completely new ones can be created. As a result, the holistic practise must stay up to date on the latest information and ensure that no outdated codes are being used, which could cause problems with insurance billing.

Experienced billing provider can guide your practise in the insurance billing process, reducing denials and increasing revenue. Continue reading this page to learn more about billing and coding.

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