Massage Therapy Prescription Submission Form Premera Blue Cross P.O. Box 91059 Seattle, WA 981119159 Customer Service: 18007221471 Please mail the completed form to the above address. A copy of the.

How it works
  • Open form

    Open form follow the instructions

  • Easily sign form

    Easily sign the form with your finger

  • Share form

    Send filled & signed form or save

How to fill out the Massage Prescription Template online

Filling out the Massage Prescription Template online can streamline your process of obtaining massage therapy services. This guide will walk you through each section of the form, ensuring that you complete it accurately and effectively.

Follow the steps to complete the Massage Prescription Template.

  1. Click ‘Get Form’ button to obtain the Massage Prescription Template and open it in your preferred online editor.
  2. In Section A, enter the patient information. Provide the member/patient name, date of birth in the format mm/dd/yyyy, and the Premera member identification number. Ensure that all details are accurate to avoid any processing delays.
  3. Proceed to Section B, where you will input the referring provider's information. Enter the name and phone number of the referring provider, ensuring the phone number is formatted correctly.
  4. In Section C, attach your written prescription. Ensure that the diagnosis (ICD-9 code), number of visits, and start date are clearly indicated. Clear legibility is crucial to prevent the form from being returned.
  5. After completing all sections, review your entries for accuracy. Once confirmed, you can save changes to your document, download it for printing, or share it as required. Lastly, remember to mail the completed form and a copy of the prescription to the provided address.

Complete your Massage Prescription Template online today for a smooth process!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

New Jersey Board of Massage and Bodywork Therapy

Apr 19, 2021 — Initial form for individuals or entities that employ another person to...

Learn more
How to get medical insurance to cover massage...

Mar 23, 2018 — Example questions: I've received a prescription for medical (or...

Learn more
Medicare - CMS

FORM CMS-2552-10. 4001. RPCH - Rural Primary Care Hospitals. RT. - Respiratory Therapy...

Learn more
Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Can a massage therapist bill for 97124?

CPT 97124 can be reported and reimbursed when massage therapy, including effleurage, petrissage, and/or tapotement (stroking, compression, and/or percussion) is medically necessary and at least one of the following conditions is present and documented.

The CPT codes massage therapists can use without question are: 97010 - hot and cold packs; 97124 - massage; and 97140 - manual therapy.

What Are the Specific CPT Codes that Massage Therapists Can Use? CPT Code 97124 Massage Therapy. CPT Code 97140 Manual Therapy. CPT Code 97112 Neuromuscular Re-education. CPT Codes 97010 Hot/Cold Packs. CPT Codes 97110 Therapeutic Exercise.

97124 is the CPT code for massage therapy; it falls under Physical Medicine and Rehabilitation Therapeutic Procedures. CPT code 97124 is maintained by the American Medical Association (AMA). Massage therapy CPT code is a time-based code or service, i.e., 15 minutes.

What is the massage therapy CPT code in Medical Billing? 97124 is the CPT code for massage therapy; it falls under Physical Medicine and Rehabilitation Therapeutic Procedures. CPT code 97124 is maintained by the American Medical Association (AMA).

CPT 97124 - Therapeutic Massage Therapy. CPT Code 97124: Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage, and/or tapotement (stroking, compression, percussion).

CPT code 97124 is more so directed at massage therapy, while 97140 is actually for manual therapy. When using either of these massage therapy billing codes, be sure to cite these exact treatment procedures in your claim to ensure coverage.

97110 Therapeutic Exercise Describes therapeutic exercises applied to a single or multiple body parts to develop strength, endurance, range of motion, and flexibility within 15-minute intervals. Must be applied by a licensed healthcare professional.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

If you believe that this page should be taken down, please follow our DMCA take down process here.

Massage Prescription Template Form

This form is available in several versions. Select the version you need from the drop-down list below.

Get Massage Prescription Template