need workers comp and no fault law regulations regarding coverage for
massage therapy  in new york state. Need to know how to be able to
bill for treatments for massage, any limitations in regards to
massage, how to bill for and receive payments under WCB and NF. Also
need average payments under WCB and NF for massage therapy rendered by
a massage therapist.

Hello -

The policies of Workers Compensation and No Fault are discussed below.
 Please don't hesitate to request further clarification on this
information.  Thank you!


Worker's Compensation Policy
---------------------------------------------
Worker's compensation does not recognize stand-alone massage
therapists or accupuncturists.  One must be a medical doctor,
chiropractor, or physical therapist to receive compensation for
massage therapy through NYS worker's compensation provisions.

If you do qualify to receive payment from worker's comp, all billing
is handled through the employer's insurance company.  The only contact
the massage therapist should have is through the mailing of a copy of
the patient's report to the appropriate WCB office for recordkeeping. 
Everything else is transparent to the practitioner.

For more information, contact Theresa at the WCB Health Providers
Administration Office, 518-402-6187

Worker's Compensation Website NYS
http://www.wcb.state.ny.us/



No Fault Policy
---------------------------------------
No Fault Insurance DOES does have provisions for massage therapy.  No
special authorization is needed; you must be a licensed massage
therapist.  There are three different ways for billing under No Fault
-- one of which is to just bill your client directly, and have them be
reimbursed by No Fault.

The different ways of billing for the work are discussed here:
http://www.ins.state.ny.us/rg030218.htm

Read more about No Fault here; the first 3 links are the regulations:
http://www.ins.state.ny.us/r68_link.htm

To find the "going rate" for massage therapists under No Fault law,
you'll need to obtain a copy of Workers Compensation Board "Physical
Medicine Fee Schedule", available from Ingenix:

Ingenix
877-464-3649

No Fault uses this WCB fee schedule.  "Physical medicine" code 97124
might be the one to look at first.

For more information, contact Chris at the No Fault line:

Chris
212-480-5592



Search strategy:
 WCB and NYS Insurance offices

---

Request for Answer Clarification by drdohner-ga on 27 Sep 2005 21:11 PDT

So as a physician I can bill for a massage therapist's work so long as
it is medically necessary and prescribed  by a MD or chitopracter? Do
I bill under a physical therapist code? Would I have to be on the
premises in order to bill or is it viewed as an incidental service?
Thanks, Eric Dohner, MD

---

Clarification of Answer by jbf777-ga on 28 Sep 2005 12:46 PDT

For Workers' Compensation cases, a WCB-authorized medical doctor can
bill for the work of a message therapist or physical therapist if
under your supervision.   According to ground rule 11 in the workers'
compensation medical fee schedule, "supervision" is defined as such:
"Must be present in the office suite and immediately available to
provide assistance and direction throughout the time services are
performed."   With regards to billing -- yes, you would bill under the
PT code.

With No Fault, you have more freedom, since stand-alone massage
(off-site) therapy is directly supported with no authorization needed.

Please feel free to ask for any additional clarification before rating this answer.


Thank you,

jbf777