resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
The CDC came out with a report in March 2013 that suggests 1 in 50 children will be diagnosed somewhere on the autism spectrum – significantly higher than the 1 in 86 figure that came out in 2007. What does this mean moving forward, particularly for children?
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Leaving Footprints on Capitol Hill: Tribute to Dr. Kenneth Luedtke (1930-2014)
It was with great sadness that I heard of the passing of Dr. Ken Luedtke.
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
Unlevel Pelvis in the High-School Athlete: Exploring Causes and Effects
The unlevel pelvis is all too common in the high-school athlete and if not detected, will likely cause a lifetime of musculoskeletal issues. Any provider who doesn't look for this common finding is missing critical information.
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
October, 2009, Vol. 9, Issue 10
An Issue of Reimbursement
By Vivian Madison-Mahoney, LMT
Most patients and massage therapists are not aware of the fact that "massage therapy" and/or "manual therapy techniques/myofascial release" is a covered service by most insurers, including Medicare and self-insured employer plans which fall under the Federal guidelines of ERISA (Employee Retirement Income Security Act).
However, there is a catch.
While insurance companies do pay for the services we perform, they do not directly reimburse us for our services. Instead insurers will pay PTs, MDs or DCs who have massage therapists on staff. (I might add at increased costs to employers and insurers.) Therefore, we are not faced with the issue of getting insurers to reimburse for our services; it is an issue of getting them to directly pay those who perform this hands-on, intensive, time-consuming work.
Patients typically must go through practitioners who have massage therapists on staff to receive full insurance coverage. But many practitioners do not have massage therapists/bodyworkers on their staff. In this case, a treating physician may write a prescription for medically necessary massage/manual services for the patient. However, because the patient is dealing with a referral (and a non-staff therapist), the patient will very likely have to pay out-of-pocket for the service. As a result, many patients will simply choose not to pay for the much-needed treatment.
I have no objections to physicians, chiropractors, etc. hiring massage therapists to perform work in their offices as an employee or independent contractor if this is what both parties prefer. However, more often than not, I hear that both the therapist and physician would rather work on a referral basis. Unfortunately, this is only possible now with liability type insurance and a few health insurance exceptions. Therefore, only very limited coverage is available to patients in comparison to what would be available if insurers provided coverage and direct reimbursement for all medical referrals to massage therapists.
The Time Is Right
Health insurance coverage is expanding as we educate insurers, legislators, employers and the public to the benefits of massage. Employers across the nation (including insurance companies) have massage therapists come to their offices to provide stress relief massage therapy to their employees and incorporate massage therapy in their wellness programs. They are beginning to understand and value the benefits of massage therapy when performed by those who are trained and licensed to provide this service. However, they do not yet realize the cost-effective savings of reimbursing massage therapists directly.
If insurers or employer group plans allowed direct reimbursement to state-licensed, certified or trained therapists to provide therapy for prescribed medical conditions through their health insurance programs, employees would be able to better stay on the job, return to work faster after injury, and be more productive. Reimbursing other practitioners for services provided by massage therapists only increases insurance companies' payments as they are paying a "middle-man", costing them more in the long run. If other health insurers, Medicare and the VA directly reimbursed state licensed and/or certified massage practitioners, their costs could be considerably reduced due to direct provider reimbursement. Direct reimbursement to those providing the services would also decrease patient's co-pays and in some cases, their deductibles.
As mentioned, most of us who have been accepting insurance cases have only been successful with liability type insurance cases such as auto, work, or slip-and-fall as well as some health insurance situations. When I began in this field in 1984 no one was billing insurance for massage. To my knowledge not many physicians knew about massage therapy as a benefit to their patients. Before I sold my practice, in one county alone, more than 172 physicians were referring patients to my office. Now they are doing it across the nation. They understand the benefits to their patients.
Now is the time to make insurance companies, self-insured employers, Medicare, VA and private health insurers understand the value of these services and savings to them as well.
I know, some are against direct reimbursement. Some worry that their fees will be lowered if insurance companies were able to reimburse them. But reimbursement would be an option; therapists would not be obligated to change their way of doing business or forced to accept insurance for reimbursement. We need to always protect our rights to choose as well.
But, I can say this: since 1984 when I began billing insurance and since 1990 when I began providing CE courses on insurance billing procedures, laws and rules to massage therapists, I haven't seen any massage therapist doing any worse because of it. If we were directly reimbursed by health insurance companies, working under the prescriptive orders of a physician and only able to make what the going Medicare or state workers' compensation fee schedules are, it would surely be more rewarding for those therapists losing business from out-of-pocket patient referrals.
I know for myself, we worked on volume, charging extremely low fees such as $58.50 and $65 per hour (or more), and built a massage practice earning a half million a year back in the late 80s and early 90s. There are many therapists who would be happy to make anything working in a field they love rather than wondering where the next dollar is coming from or searching for other forms of income as, sadly, I so often see these days. So if money were pretty much guaranteed, would it not be better to have the capability to accept or reject new clients/patients as your office (or hands) permitted?
When contacting an insurance company, many massage therapists hear the following: "We will reimburse a PT or MD to provide massage therapy or manual therapy services but not a massage therapist." "We do not allow massage therapists to become in-network or participating providers." While we may complain that this seems like discrimination, it will not change things as they are. We need to work together to change the way insurers reimburse for physician-prescribed services.
What's Your Take?
I realize reimbursement is not for every therapist. For those of you who command much higher fees, you may be concerned by this possibility. I want to hear from therapists on both sides of the issue.
As a health care advocate, I'm requesting feedback and possible future assistance from those interested in helping to reform the way health insurers, Medicare, VA and employer group plans reimburse for massage/manual therapy services.
Please email me at or send mail to: Massage Today/MPA Media, 5406 Bolsa Avenue, Huntington Beach, CA 92649.
Your input is welcome and appreciated!
Click here for more information about Vivian Madison-Mahoney, LMT.
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