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Is massage therapy reimbursable under the new PIP law?

Jul 16, 2014
Shamis & Gentile, P.A.
Is Massage therapy reimbursable under the new PIP Law

Is massage therapy reimbursable under the new PIP law? Does PIP pay for massage?

Massage Therapy Reimbursable Law:

Statute for PIP: 627.736(1)(a) 5. Medical benefits do not include massage as defined in s. 480.033 or acupuncture as defined in s. 457.102, regardless of the person, entity, or licensee providing massage or acupuncture, and a licensed massage therapist or licensed acupuncturist may not be reimbursed for medical benefits under this section.

Statute for Massage Practice: 480.033 (3) “Massage” means the manipulation of the soft tissues of the human body with the hand, foot, arm, or elbow, whether or not such manipulation is aided by hydrotherapy, including colonic irrigation, or thermal therapy; any electrical or mechanical device; or the application to the human body of a chemical or herbal preparation.

Our Interpretation:

No. However, we recommend that chiropractors implement manual therapy instead.

In regards to the new law, there’s two parts we’d like to examine:

The first part states, “Medical benefits do not include massage as defined by 480.033.”  Though chapter 480 is the law that regulates massage therapists, it doesn’t regulate chiropractors. I would argue in favor of chiropractors being reimbursed for massage if this were the only part of the law.

The second part of the law is a “catch all”. It states “regardless of the person, entity or licensee providing massage.” Due to this part, I think it’s fairly evident that the legislators were reluctant to allow reimbursement for massage by any medical provider.

You should also be aware of the fact that Florida Legislators could have mentioned CPT code 97124 (massage) in the law but they didn’t! They could have just said “PIP will not reimburse 97124” but, they decided to take the long route.

Based on the countless number of PIP claims I’ve seen under the “old PIP law” I know that insurance companies are most likely going to deny 97124 every single time they see it. So, we’re suggesting that clients perform manual therapy instead of massage therapy , in order to avoid the headache and hassle!



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