Please note that this article contains information that is only relevant to American clinics.

 

Therapists providing treatment under Medicare Part B have likely noticed a similarity between manual therapy (CPT 97140) and massage therapy (CPT 97124) and what the treatment codes entail. But one of the most glaring differences is the difference in payment between the two. On average, one unit of massage therapy nets nearly $3.00 more for the provider—which doesn’t seem like a lot—but when you consider the vast number of units provided per month, it’s easy to see why some facilities are inclined to bill one treatment over the other. In this article, we’ll be discussing what each of these treatments entail, and how you can go about billing them.

 

The first question on every therapist’s mind before they begin offering a service is “Will the Medicare program pay for this treatment?” In the case of massage and manual therapy, the answer is a resounding “yes.” However, therapists can run into issues if they attempt to bill these two CPT codes on the same day—and the reason for that is the perceived similarities between the two treatments.

 

Are you familiar with the 8 minute rule? Click here to read about it. 

 

As per the American Medical Association (AMA), massage therapy (CPT 97124) includes kneading, wringing, skin rolling, rhythmic percussion, cupping, hacking, or plucking. For manual therapy (CPT 97124), the AMA states that it must include one or a combination of the following: joint mobilization and manipulation, manual traction, soft tissue mobilization, or compression bandaging. Thus, if you want to invoice either of these CPT codes, your documentation must specifically cite the above techniques.

 

As of 2018, the amount that Medicare can pay for one unit of massage therapy is nearly $3 more than one unit of manual therapy. But as a rule of thumb, you should only bill the CPT codes that accurately describe the treatment provided. You should never bill a code simply because it yields a higher payment. Doing this is a sure-fire way to land yourself in hot water.

 

We hope that you found this article helpful. For more content related to Medicare, please visit Gawenda Seminars and Consulting: https://gawendaseminars.com/

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