Medical Billing

# How Insurance Billing for Massage Therapists Can Be Performed Under the 97124 CPT Code?

- October 22, 2024
- Posted by Kristen Edwards

28 Jul

Accurate billing has been one of the essential parts of optimized practice management. The importance of using standard codes cannot be overstated. Oftentimes when your practice is performing at its best, you don’t want to get stuck in the billing ventures that may delay the RCM. Particularly, one of the coding and billing sides in the medical industry deals with massage therapy services. A wide range of CPT codes is there when it comes to insurance billing for massage therapists.

Considering the above discussion, this blog covers the most common CPT codes used for billing massage therapy services. In addition, you will have extensive information about the importance of CPT codes in massage therapeutic services.

## Why is Insurance Billing for Massage Therapists Important?

Accurate insurance billing for a massage therapist is important due to maintaining optimized practice and streamlining the revenue management cycle. Billing and coding experts need to follow a guideline provided by HCPCS to use CPT massage therapy coding which can guarantee accurate billing if used efficiently.

Not only this but through accurate billing procedures, the insurance claims for the services rendered can be reimbursed in a timely fashion. This means your revenue management cycle is less likely to be interrupted if you are greatly after optimizing practice revenue with timely reimbursements. Either accurate or inaccurate insurance billing will affect the overall practice of a therapist.

## How Does Medical Insurance Cover Massage Therapy?

source:myemed.net

It is important to understand that not all insurance companies accept massage therapy. This is why it is not always guaranteed that your patients’ insurance will reimburse you back for your services.

For this, discussing the payment and insurance expectations with your client from the initial contact is important. Getting financial things discussed before the visit and services will reduce the time consumption at the time of the visit and also when it’s time to reimburse.

Also, it is important to ask the client whether their insurance company covers the services for massage therapy under the plan they have purchased. If yes, then it is also required to check whether the massage therapist covers the massage therapy, as some insurance plans cover massage from a physical therapist.

Many times when there’s an auto accident, it becomes necessary to remain in contact with the legal manager of your service to cater the insurance for the service they are insured.

## The Most Common 97124 CPT Code for Therapeutic Procedure

CPT code 97124 is used for therapeutic procedures that involve one-on-one interventions with patients to improve their functional abilities. The most common type of therapeutic procedure associated with CPT code 97124 is therapeutic exercises.

Therapeutic exercises involve activities that help improve strength, range of motion, flexibility, coordination, and balance. These exercises can be tailored to the patient’s specific needs and may include activities such as stretching, resistance training, and cardiovascular conditioning.

Other therapeutic procedures associated with CPT code 97124 include manual therapy techniques such as joint mobilization or manipulation, neuromuscular re-education, and therapeutic activities such as gait training or balance training.

It’s worth noting that the most common use of a CPT code can vary depending on factors such as the provider’s specialty and the patient population they serve. So while therapeutic exercises are commonly associated with CPT code 97124, it’s possible that another type of therapeutic procedure could be more commonly used in a particular setting.

## Does Medicare Cover Massage Therapies?

Right now massage therapies and treatments are not covered by Medicare. But there are insurance sources that do cover massage therapies and treatment but they vary from state to state. They are;

- Personal Injury (PIP)
- Major medical plans (Blue Cross, Blue Shield, Cigna, United, Aetna, etc.)
- Workers compensation insurance

It is also essential to understand that just knowing the insurance provider’s name is not enough. A therapist must also know the insurance plan and the therapies it covers and determine what vendor the client uses for their insurance service. Before starting the treatment, confirming the details with the insurance provider is vital. You can directly contact the insurance provider via the contact number provided by the patient medical card and the policy information.

### How can a Massage Therapist Bill the Insurance?

A massage therapist can bill the medical insurance, as long as;

- The therapy service is the necessary part of the treatment plan prescribed by a chiropractor, DO, or MO,
- The therapist is licensed
- The therapist has an NPI number. If you lack a valid NPI number as a therapist, you can apply to get one here.

### Who Manages Massage Therapy CPT Codes

CPT codes are regulated by the American Medical Association (AMA) and are particularly called Current Procedural Terminology. AMA manages the codes that give the structural and procedural codes that define the services and therapies provided by physicians and therapists across the country.

### What are the Most Common CPT Codes in Massage Therapy?

The massage therapist can bill the insurance by using the following codes;

- 97010 Cold and Hot Pack Therapy
- 97140 Manual Therapy (Advanced Massage Therapy Techniques)
- 97124 Massage Therapy (Basic Swedish Massage)
- Manual 97140 and Massage 97124 are more divided into 15 minutes increments where you can be paid for putting up more time with the clients including tapotement, effleurage, petrissage, percussion, and compression.
- 97140 – Manual Therapy (advanced Massage Therapy Techniques)
- Massage (97124) and manual 97140 also are broken down into 15 minutes increments.

Medical billing and credentialing services can help you get accurate billing and claim with no delays in reimbursements, such as Sybrid MD. So just hire one today and put your best step forward.

## CPT Code 97140: Manual Therapy Techniques

CPT Code 97140 refers to manual therapy techniques such as mobilization, manipulation, physical lymphatic drainage, and manual traction. This code is commonly used by physiotherapists, chiropractors, and other medical professionals to describe hands-on therapies intended at increasing function, relieving pain, and aiding recovery.

The procedures covered by this code include soft tissue mobilization, which involves modifying muscles, fascia, & tendons to release tension and increase mobility. Joint mobilization is also incorporated, which helps to enhance the range of motion and relieve pain in various joints.

Furthermore, manual lymphatic drainage is a specialized method that reduces edema and improves lymphatic flow, whilst manual traction stretches and mobilizes joints and soft tissues. Billing for CPT Code 97140 is done in 15-minute increments, which necessitates careful documenting of manual therapy time throughout patient sessions. This code is frequently billed alongside other treatment codes, including 97124 for massage therapy and 97110 for therapeutic exercises. It is critical to confirm coverage with insurance carriers because policies vary and some may demand particular diagnoses or paperwork to allow the use of this code. Proper and precise documentation of services delivered is required to back up any claims related to this code.

## FAQ’S – Insurance Billing for Massage Therapists

#### What is CPT Code 97140 used for?

CPT Code 97140 is utilized for the bill for manual therapy treatments such as mobilization, manipulation, lymphatic drainage, and traction. These treatments are intended to increase function, alleviate pain, and promote patient recovery.

#### Can CPT Code 97140 be used with other codes?

Yes, CPT Code 97140 is frequently billed alongside other treatment codes, such as massage therapy CPT code 97124 is used, and therapeutic exercises code 97110 is based on the services delivered during a patient session.

#### What types of conditions are treated with manual therapy?

Manual therapy techniques covered by CPT Code 97140 can be used to treat a variety of musculoskeletal disorders, such as back pain, neck pain, joint stiffness, sports injuries, and post-surgical rehabilitation.

#### How does manual therapy differ from massage therapy?

Although both manual therapy and massage treatment use direct approaches, manual therapy (CPT Code 97140) primarily focuses on joint mobilization and soft tissue manipulation to enhance function and reduce discomfort. Massage therapy (CPT Code 97124) is largely concerned with relaxation and muscle tension alleviation.

#### What specific techniques are included under CPT Code 97140?

CPT Code 97140 covers a variety of manual treatment procedures, such as:

● Joint Mobilization: Use gentle movements to increase range of motion.

● Soft Tissue Mobilization: Techniques to relieve tension in muscles and fascia.

● Manual traction involves gently tugging on joints to release pressure and improve movement.

● Manual Lymphatic Drainage: A massage method that promotes lymphatic circulation and reduces swelling.

#### What are the expected outcomes of manual therapy billed under CPT Code 97140?

Patients who receive manual therapy may have an increased range of motion, less discomfort and stiffness, greater muscular function, and improved general physical performance. Individual illnesses and treatment goals can all influence the outcome.

#### What qualifications should a practitioner have to perform manual therapy?

Manual therapy practitioners, such as physical therapists, chiropractors, and massage therapists, should be properly licensed and trained. Advanced certificates in manual treatment might further increase their expertise.

#### Key Differences Between Timed and Untimed Codes

#### What is the 97124 CPT code description for massage therapy?

CPT code 97124 is used to charge for therapeutic massage therapy, which includes techniques such as stroking, kneading, and percussion.

#### Can massage therapy be billed under CPT 97124?

Yes, the insurance code for massage therapy is also CPT 97124 when utilized as a medically required therapy plan.

#### How does procedure code 97124 apply to insurance claims?

The procedure code 97124 is used on insurance claims to bill for medically prescribed massage therapy services.

#### Does insurance cover massage therapy with CPT 97124?

CPT 97124 coverage is determined by the insurance provider, and permission may be required based on medical necessity.

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