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For a massage to be covered by insurance, your best bet is to get a prescription or referral from your doctor. Even then, the insurance company doesnt have to agree to pay for it. Medicare, for example, doesnt cover massage therapy at all, so you would have to pay for 100% of the costs.
Who can write the prescription? The answer to this will depend on your individual insurance plan, as some require that it comes from an MD. But, more often than not, the prescription can come from any qualified healthcare provider, such as your primary care physician, chiropractor, naturopath, or nurse practitioner.
ICD-10-PCS Code 8E0KX1Z - Therapeutic Massage - Codify by AAPC.
97124 Massage Therapy Describes the work inherent in massage, which is a separate and distinct service from codes 98940-98943. CPT code 97124 describes work including effleurage, petrissage, and/or tapotement (stroking, compression, percussion) for every 15 minutes.
What Are the Specific CPT Codes that Massage Therapists Can Use? CPT Code 97124 Massage Therapy. CPT Code 97140 Manual Therapy. CPT Code 97112 Neuromuscular Re-education. CPT Codes 97010 Hot/Cold Packs. CPT Codes 97110 Therapeutic Exercise.
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97124: Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion). 97140: Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.
Oftentimes they will require a letter of medical necessity, which is typically provided by your physician or therapist.
Medicare doesnt cover massage therapy. You pay 100% for non-covered services, including massage therapy.
Talk to your primary care provider. In many HMOs and other health plans, this doctor is the one who must authorize the referral. Discuss medical necessity with the doctor. Figure out how that medical professional will diagnose a condition that can formally necessitate medical massage.
Physical therapy A person is responsible for 20% of the Medicare-approved amount up to their deductible for treatments. However, the program does not currently cover massage therapy, so a person is responsible for 100% of the costs of this treatment for back pain.

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