How to set yourself up with a massage room to bring in new patients, be properly compliant, and most importantly profitably
What an amazing opportunity it is, for both your office and your patients, to have a massage room with massage services offered in your chiropractic practice.
I happen to be a member of a massage chain where I pay $59 a month and that covers a one-hour massage, once a month. Should I need any additional massages I get the member discounted fee there and they don’t bill insurance. I can’t tell you how many of your patients are going to places like this for a massage and not coming to the chiropractic office when they could be getting everything under the doctor’s care.
Stop money going out the door
Do you have a room that could be used for massage? You can begin to capture some of that money that’s actually being spent elsewhere.
Make entry into your office easier by marketing massage. It’s often an easier entry point than walking into a chiropractic office because they know massage, they understand massage. Once the massage patient is admitted for massage, start with a questionnaire that’s filled out first. Then have them briefly checked by the chiropractor to ensure that it’s safe for them to be massaged.
As the massage is being conducted, that massage therapist can point out potential areas that would benefit from chiropractic care. Consider scripting such as, “If you’re continuing to have this problem I’d love to get you in to see Dr. Fred over here,” facilitating an easy entry point to chiropractic because they’re already familiar with your office.
Set up a massage room for a new-patient stream
Many payers have very strict rules about how massage is rendered, for how long, and for what conditions. Providing massage for cash payment is no problem, but make sure your fees are appropriate. Do not bill one fee to insurance and a different to cash. If you wish to offer discounted fees for cash, there are absolutely ways to do so safely and compliantly, such as with a discount medical plan network.
It breaks my heart when I do an on-site visit and I see a whole wing of a doctor’s practice or several rooms that are just filled with junk and they’ve got a massage room and a therapist that’s not very busy. Why would we not be promoting massage to expose potential patients to chiropractic in the process. I’ve seen it work for many, many years — I’ve seen it work with me. I know my chiropractor doesn’t offer massage, that’s why I’m a member elsewhere, and I’m happy to pay cash for that.
Massage gift certificates can be a hot seller for major holidays, especially for Valentine’s Day or Mother’s Day. Offer these for purchase to your existing patients to expose others to the office as well.
5 things to consider
Massage can be very profitable for chiropractic offices. Here are five tips and rules to enforce among your staff and practice:
1. Is tipping allowed? — The fine print of your contracts with third party payers might forbid this practice if you are billing the massage to insurance. Any solicitation that encourages the patient to offer a tip can be enough to trigger an offense. A patient should never be made to feel as though they are expected to pay more than the contracted amount, but patients can tip without prompting.
2. Avoid illegal inducements — Massages make great gifts, but doctors are not allowed to offer a Medicare or Medicaid beneficiary any remuneration that can influence the beneficiary’s selection of a particular provider. “Gifts” from a doctor cannot exceed $15 per occurrence or a total of $75 per year. Avoid giving away free massages and the potential $10,000 penalty per occurrence.
3. Use only qualified staff – Your state regulations might specifically state that only licensed massage therapists (LMTs), physical therapists (PTs), and/or DCs can perform massages. If billing the massage to the patient’s insurance, they may only pay for massages performed by the doctor. Always verify a patient’s insurance benefits to ensure that the rules are being followed.
4. Prove medical necessity — If billing the massage to insurance, many states or companies will require that the service be medically necessary. This requires that the patient has an exam and an active treatment plan on file with enough evidence to support the diagnosis necessitating a massage. Make sure patients are aware of their financial responsibility for the massage.
5. 97124 vs 97140 — Massage therapy consists of several techniques including effleurage, petrissage and/or tapotement (stroking, compression, percussion), and the most appropriate CPT code to use for this service is 97124. Other types of muscle work such as trigger point therapy, myofascial release, mobilization, and manual traction are best billed as 97140.
Cash or insurance billing for massage
Patients will pay cash, but here’s the problem — if we get them used to having insurance pay for massage, like a baby with a pacifier, once they are used to that, it’s very difficult to do it another way. Beginning to have a patient with insurance get used to having it cover massages, it’s difficult to help them understand when massage wouldn’t be covered.
But if you’d like to really maximize massage therapy in your practice as another cash profit center, make sure to set yourself up with a massage room to be properly compliant, and most importantly profitably.
KATHY “KMC” WEIDNER, MCS-P, CCPC, CCCA, is a Certified Medical Compliance Specialist (MCS-P), Certified Chiropractic Professional Coder (CCPC), and Certified Clinical Chiropractic Assistant (CCCA). Since 1983, she has been providing chiropractors with reimbursement and compliance training, advice and tools to improve the financial performance of their practices. She leads the largest team of certified specialists in the profession at KMC University and is known as one of our profession’s foremost experts on compliance, Medicare, documentation and CA development. She or any of her team can be reached at info@kmcuniversity.com or by calling 855-832-6562.
