When doing business with insurance companies (contracted with insurance companies), one must then follow certain rules and regulations when charging any patient/client, namely that fees for services rendered are consistent and non-discriminatory. You cannot charge one entity/person one fee for a service, and another entity/person a different fee for the same service. This is against OR/WA (& most other) State regulations.

Currently, LMTs are not technically considered a healthcare provider, which makes them exempt from HIPAA. When an LMT is contracted with any insurance company, they are then required to abide by HIPAA regulations regarding the security and privacy of their patient's/clients medical information.

Great question! This is ever-changing, so it is best to find a professional to help with any questions regarding getting in-network with local insurance companies and which ones are better to work with than others.

Understand the limits of your scope of practice in the State in which you work and which State regulations affect your field, and get educated on how to get the most beneficial and accurate info during the verification of benefits check before treating any patients/clients, including any prior-authorization requirements. It is also important to understand just how much you might get paid by an insurance company by reviewing the fee schedule they provide during contracting. Don’t understand the contract? Call the insurance company and have them explain it to you, they are legally obligated to break it down for you.

97124 is massage therapy and can have its own benefit category, depending on the insurance company. 97140 is manual therapy and is a part of the physical therapy/rehabilitation benefit category. If the patient has massage therapy benefits, use 97124. If they only have PT benefits, use 97140. There are insurance companies that assign the same benefits for PT to massage therapy, but not all do this so it’s important to understand the difference between the two.