Here’s what chiropractors need to know about physical medicine services and therapeutic massage

Here are some important reminders to keep in mind regarding physical medicine and therapeutic massage.

Physical medicine

• Blue Cross Blue Shield of Michigan doesn’t require an order from an M.D. or D.O. for the first physical medicine service provided to a member.

• We only pay chiropractic physicians for additional physical medicine services they provide to a member if the chiropractor sends a written physical medicine treatment plan to the member’s medical doctor or doctor of osteopathy and the physician agrees to the treatment plan and signs it.

• The physical medicine treatment plan must be signed by the member’s M.D. or D.O. before any additional covered physical medicine services provided to the patient will be paid.

• The signed treatment plan must be filed in the member’s medical records at the chiropractic physician’s office.

• For Blue Care Network, physical medicine services require authorization through Landmark. Authorization through Landmark is required of all health care providers performing physical medicine procedures, including M.D.s, D.O.s, doctors of chiropractic and physical therapists.

Therapeutic massage
Blue Cross Blue Shield reimburses for therapeutic massage as a part of an overall physical medicine treatment plan if the following criteria are met:

• It’s provided as part of a formal course of physical therapy in addition to other therapeutic interventions on the same date of service.
• It’s provided in the early, acute phase of therapy to address a musculoskeletal problem and is generally limited to two weeks of treatment.

Keep the following in mind:

• Massage therapy alone, either as a one-time service or as a series of massages over time, isn’t a covered benefit.
• All Blue Cross requirements related to the identification and qualifications of approved providers of physical therapy apply to the providers of massage therapy.
• Blue Cross rules regarding orders and documentation of rehabilitation services apply to the provision of massage therapy.
• All Blue Cross rules and requirements related to “incident to” billing for physical therapy apply.

Medically necessary therapeutic massage may be delivered by participating providers, when such massage is within their scope of practice. Chiropractors may perform this service when performed as a part of a complete physical medical plan; they may not supervise other provider types in performance of therapeutic massage.

Blue Cross doesn’t reimburse for therapeutic massage and physical medicine services provided by massage therapists, therapy aides, exercise physiologists or kinesiotherapists, even under the supervision of an eligible provider type.

For Michigan Education Special Services Association members, additional physical therapy procedure codes, including massage therapy, are payable when supervised and billed by a chiropractor. Chiropractors can delegate physical medicine services, including massage therapy, to another person. The chiropractor isn’t required to provide them directly.

A physician (M.D. or D.O.) agreement or signature isn’t required on a treatment plan for MESSA members.

As always, be sure to verify the contract benefits of a member before performing therapeutic massage.

If you have any questions, contact your provider consultant.