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I was just wondering if there are there any Family Med docs that are either DO's or are MD's that use OMM and incorporate that into their practice?

I've heard that insurance usually pays pretty poorly for OMM. I've also heard that if you opt in for Medicare, you are not allowed to charge the Medicare patient over what Medicare dictates as the official price.

So if you are a family medicine doctor and granny comes to see you and asks for OMM, you aren't allowed to charge extra to make it worth your time. Is my understanding correct?

My questions are, is doing OMM financially worth it? Has anyone turned it into a cash-only type of thing? How do you do cash-only OMM while taking Medicare patients (likely the largest demographic in the future) if you charge one group cash while the other group you aren't allowed to charge over what Uncle Sam says you get paid?

I know it's a lot of questions, but any insight into this topic would be great!

Thank you!
 

oxytocin

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Where I am now there are two Asian female DOs that routinely have OMM clinic on Saturday mornings in their respective offices.
Do they take cash patients for omm? How about for regular medical visits
 

MidwestFM

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At our residency clinic, we routinely charge for both an office visit AND OMM when it is done. In fact, this is one of the things differentiating osteopathy from chiropractic. An evaluation should be done each time prior to the treatment vs. just doing a series of treatments.
We haven't had any problems getting paid for both with proper documentation.
 

JaggerPlate

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At our residency clinic, we routinely charge for both an office visit AND OMM when it is done. In fact, this is one of the things differentiating osteopathy from chiropractic. An evaluation should be done each time prior to the treatment vs. just doing a series of treatments.
We haven't had any problems getting paid for both with proper documentation.
There are far, far more things differentiating osteopathy (osteopathic manipulation) from chiropractic. Far, far more.
 

aecuenca2

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You can't bill for consults for Medicare or Senior HMO patients.

You can bill for regular/new patient visit, -25 modifer, then bill OMT for number of areas treated
 

cabinbuilder

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I do OMM every day on 1/4 of my patients. We bill $90 per 2 segments. SO if you do full body with 7-8 segments that is $360 plus the office visit. I haven't heard any flack from the billing folks. I don't do OMT on private pay or idigent care since they cant afford it. Otherwise it can make you money. Not sure where the OP is getting their info.
 

JaggerPlate

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I do OMM every day on 1/4 of my patients. We bill $90 per 2 segments. SO if you do full body with 7-8 segments that is $360 plus the office visit. I haven't heard any flack from the billing folks. I don't do OMT on private pay or idigent care since they cant afford it. Otherwise it can make you money. Not sure where the OP is getting their info.
Sorry, but just looking for clarification ... you bill insurance for the OMM? Medicare, private, etc???
 

MidwestFM

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Seems to me the question has been answered, but I'll have another go at being more specific...
Yes, Medicare, Private insurances, (and in my area even Medicaid) all pay for OMM in addition to an office visit.
 

JaggerPlate

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Seems to me the question has been answered, but I'll have another go at being more specific...
Yes, Medicare, Private insurances, (and in my area even Medicaid) all pay for OMM in addition to an office visit.
I know that after 2008 you can bill them separately, I was just asking cabin builder if he was charging patients 90 out of pocket for two regions, if that was what he billed the insurance companies, or if that is what he received from the insurance companies??
 

Sharpie1

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I do OMM every day on 1/4 of my patients. We bill $90 per 2 segments. SO if you do full body with 7-8 segments that is $360 plus the office visit. I haven't heard any flack from the billing folks. I don't do OMT on private pay or idigent care since they cant afford it. Otherwise it can make you money. Not sure where the OP is getting their info.
That may be what you bill, but likely not what they pay. Just looked up medicare's fee schedule, and for 9-10 segments it seems they pay in the range of $70
 

cabinbuilder

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Sorry, but just looking for clarification ... you bill insurance for the OMM? Medicare, private, etc???
I work for a clinic on salary. The inurance companies are billed for the OMT. If a patient is private pay, they have to pay up front or on a fee scale. Have to be careful when you have all payer types. I'm not private practice so the clinic biller takes care of it but I do my own coding. I just know the charge here is $90 for 1-2 segments. What they get in actuality I wouldn't know.
 

JaggerPlate

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I work for a clinic on salary. The inurance companies are billed for the OMT. If a patient is private pay, they have to pay up front or on a fee scale. Have to be careful when you have all payer types. I'm not private practice so the clinic biller takes care of it but I do my own coding. I just know the charge here is $90 for 1-2 segments. What they get in actuality I wouldn't know.
Gotcha. Thank you for clarifying.
 

cabinbuilder

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That may be what you bill, but likely not what they pay. Just looked up medicare's fee schedule, and for 9-10 segments it seems they pay in the range of $70
I don't do OMT on medicare patients as a rule since I use mostly HVLA and don't want to fracture any osteoporotic bones.