American Massage Therapy Association^®

AMTA Requests New Insurance Reimbursement Codes

Evanston, IL (December 1, 2004) – The American Massage Therapy Association (AMTA) has submitted a request to the American Medical Association (AMA) for two new insurance codes to be added to the CPT code book. The proposal for additional evaluation and re-evaluation codes was submitted in October, well in advance of the requirement that it be filed by December 2004. The American Medical Association’s CPT panel will hear the proposal in February 2005, with a possible decision by late spring of 2005.

“For those massage therapists who are interested in or are currently working within the medical environment and submitting insurance reimbursement claims, this will be very helpful,” said AMTA President Laurel J. Freeman. “We are very grateful to our CPT panel representative, Whitney Lowe, for all his work so far in helping us make this proposal.”

Many massage therapists use CPT codes to bill for massage therapy services. Unfortunately, the current CPT codes do not adequately represent the evaluation and assessment processes massage therapists might use. According to a 2004 AMTA survey, 37% of AMTA members use CPT codes to bill insurance. Approximately half of AMTA members have some interest in working within the healthcare environment and/or seeking insurance reimbursement for massage therapy through use of CPT codes.

AMTA formed a committee to recommend steps for coding initiatives. The committee gathered information from surveys and consulted subject-matter experts knowledgeable in both insurance billing for massage and the use of massage in treating various medical conditions that use 3rd party reimbursement. The AMTA Board of Directors agreed with the committee that the best place to start seeking changes from the CPT panel is by acquiring new codes for massage therapy evaluation and re-evaluation.

Currently, there are no codes for evaluation and assessment of massage by a massage therapist, therefore, massage therapists cannot correctly bill for the procedures. Evaluation and re-evaluation codes do exist for physical therapy, occupational therapy and athletic training. When massage therapists bill evaluation and re-evaluation procedures under physical therapy codes, their claims often are denied, because the code specifically states the person performing the procedure is working under the scope of practice of physical therapy.

Establishing evaluation and re-evaluation codes specific for massage therapists will help massage therapists bill insurance companies for 3rd party reimbursement in appropriate cases. It also will help insurance companies recognize the legitimate reimbursement claims of massage therapists.

Establishing new CPT codes can be a difficult and lengthy process. However, AMTA is hopeful the proposed new codes will be accepted in 2005, to benefit both clients and massage therapists who choose to seek reimbursement.

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