In our office, we work with many patients who have a medical prescription for massage therapy for treatment of a specific medical condition.
Medical Massage is defined as: “A treatment with the intent of improving conditions or pathologies that have been diagnosed by a physician; this procedure is utilized to focus the treatment based on the diagnosed condition.” It is a treatment that is directed by the referring doctor and carried about by our licensed massage therapists. We accept medical insurance for this and we also work with auto insurance companies as well as Labor and Industries.
The CPT (Current Procedural Terminology) code used for a medical massage in our office is 97124. The rate billed to insurance is $40 / unit. There is a maximum of 4 units billed per day.
This is the category of massages that we offer that are not doctor directed and do not require a medical prescription. There is a wide variety of massage types that our therapists are trained in. They include Swedish, sports, pregnancy, relaxation and more. The distinct difference with a wellness massage that differs from a medical massage in this office is that a wellness massage does not require a specific diagnosis, there is often not a treatment plan or medically necessary goals, there is not a need for a care plan and there is no limitations to the number of sessions one has because this service is elected at the discretion of the patient.
There is no CPT code for a wellness massage. They are not billed to health insurance. We can not bill health or auto insurance for a wellness massage. Even if a patient has health insurance, we will not bill a wellness massage to their health or auto insurance company because a) medical massage is a different and unique service & b) medical massage requires a doctors prescription.
We understand the definition of WAC code: 246-808-545. We are fully complaint with all WAC sections issued by the CQAC.
There is a a distinct difference between a medical massage and a wellness massage within this clinic. This is why the charges are as differentiated as follows:
Wellness Massage: $80/hour
Medical Massage: $40/unit (One unit equals : 8-22 minutes) (Two units equals : 23 minutes – 37 minutes) (Three units equals : 38 – 52 minutes ) ( Four units equals : 53 minutes – 67 minutes)