Frequently asked questions
It all began with a simple idea fueled by a deep passion. As a small business, I pride myself on personal attention and dedication to every detail. My approach is rooted in quality and integrity, ensuring that everything I do reflects my commitment to excellence.
Do you accept insurance?
I do NOT. Although I will be able to provide you with a detailed invoice known as a "Superbill".
A Superbill is a special itemized receipt that includes the session fee and the balance having been paid in full. It includes a CPT code, with the number of units that were used, and will include billing codes, your detailed information, my detailed information, and the dates of services.
In order to provide a superbill, you will need to have an up to date (less than 1 year old) massage prescription from your primary care provider or chiropractor. Once I have a copy of your prescription, I can then tailor your massage care to your referring providers requests, and supplement you with a superbill for you to submit to your insurance company to request reimbursement for services paid out of pocket.
Please note: Reimbursement is not guaranteed. I do not recommend you begin care with the expectation of receiving full reimbursement. You should call your insurance company first and ask for detailed information as to what services are covered.
Diagnosis Codes vs CPT Codes
One question that is often asked is if I provide diagnosis codes- the answer to this is I DO NOT. I can only provide you with a billing code, known as a CPT Code. The diagnosis code has to come from your referring provider. Diagnosis codes are known as ICD-10 codes.
A referral for massage therapy without diagnosis codes is not sufficient when you plan to request reimbursement for massage therapy.
There are two CPT codes I can use when performing massage:
97124 - massage therapy
97140 - manual therapy
I often use both modalities within your session. When working with your prescription details, I might use one more than the other and that is how I will provide the CPT code on your superbill. Only one code can be used per session.
Sessions are often billed in increments of "units". Each unit is equal to 15 minutes of hands on time. Most sessions performed are done so in 4 units for 1 hour of massage, and 6 units for 90 minutes of massage.
I recommend asking your insurance provider how much you can be reimbursed for for each code.
Questions to ask your insurance provider.
Here is a list of questions I recommend you ask your insurance company when trying to determine if requesting a superbill makes sense.
• Can I be reimbursed for massage therapy when performed by an out of network provider?
• Will I be reimbursed for sessions when performed in my home (place of service code 15)?
• How many sessions am I allowed per year? (Average sessions are limited to 1 hour = 4 units).
• Will out of network sessions count against my annual massage benefits?
• Are the CPT codes 97124 or 97140 reimbursable when performed by a licensed massage therapist?
• How much can I be reimbursed for when I provide a superbill for code 97124/97140?
Information needed on Superbill
These are the most common details needed on a superbill, I will provide all of my details so minimize risk of denials.
• NPI # - National Provider Number (this is my personal registry number for insurance companies to confirm who I am)
• CPT Codes - Current Procedure Terminology (I provide one of two codes)
• ICD-10 - International Classification of Diseases (this comes from your primary care physician)
• Billing Code - where I performed the service
• Federal Tax ID - needed to confirm transfer of payments from you to me
• License #- My state license number governed by the Department of Health
Where to send your prescription
Some hospitals and clinics will offer to fax over your massage prescription for you. Unfortunately I do not have a fax system in place to receive prescription orders. If your provider wishes to send the prescription on your behalf, they may do so by emailing:
info@nurturedspiritmassage.com
It is important that your prescription includes the diagnosis code and a clear start date. If they provide a limit on how many sessions they recommend, it is important that we follow those recommendations.
Ultimately your insurance provider will decide if your sessions are approved, and how much they are willing to reimburse. With Superbills, our goal is to maximize your reimbursement approval, but no guarantees are offered.
Beyond the ordinary
This is where our journey begins. Get to know my business and what I do, and how I'm committed to quality and great service. Join me as we grow and succeed together. I'm glad you're here to be a part of our story.