OMM Reimbursement

[(nicedream)]

Does insurance/medicare pay for OMM? If so, why don't more DO's use it? When it comes to billing, the patient wouldn't know the difference.

---

Members don't see this ad.

 

[OnMyWayThere]

The patient would know the difference between being treated via OMM or not... if you bill it without using it, it's equivalent saying you perfmormed a blood test without doing one.

I have no knowledge how billing OMM works, but I would think the compensation is **** and not worth even doing if it's for the money.

 

[(nicedream)]

Originally posted by OnMyWayThere
The patient would know the difference between being treated via OMM or not... if you bill it without using it, it's equivalent saying you perfmormed a blood test without doing one.

I wasn't suggesting billing without using it - I meant the patient wouldn't care if you did it and billed for it if their insurance/medicare is paying for it, as opposed to them getting the bill and saying they don't want to pay for OMM.

Originally posted by OnMyWayThere
I have no knowledge how billing OMM works, but I would think the compensation is **** and not worth even doing if it's for the money.

Quite the contrary, the compensation is very high.

 

[rescuetomm]

You can bill for it by using the cpt code for manipulation. It is covered by medicare and I don't think $50-80 is ****. That is on top of the other office charges. You don't do omm on patients for the money, you only do it if they need it.

 

[(nicedream)]

Originally posted by rescuetomm
You don't do omm on patients for the money, you only do it if they need it.

I realize this, but the fact is that the vast majority of DO's don't practice any OMM. Many complaints that patients present with could be ostensibly treated with OMM, often in conjunction with other treatments. Since a case could be made for the efficacy of OMM, and it pays well, I would think that more DO's would use it.

 

[Pilot]

Medicare reimbursement - non-facility (ie non-hospital, etc)

CPT Code:
98925 - OMT one to two body regions - $26.82
98926 - OMT three to four body regions - $37.01
98927 - 5-6 regions $48.07
98928 - 7-8 regions $56.66
98929 - 9-10 regions $65.10


Compare this to spirometry - CPT code 94010 - reimbursement of $28.13 - takes much longer to perform, requires expensive equipment in office, and requires supplies.

Tympanometry - CPT code 92567 - $17.74

 

[Doctor Peloncito]

Hey Pilot, is there an online billing source for these codes?

To the original poster, it is a shame that more physicians don't use OMM more often, it is what makes us different, and they will reimburse you as long as you properly chart the somatic dysfunction(s).

wbdo

 

[Pilot]

I looked these codes up a few days ago for my own personal interest. I did a Google search for "CPT codes", and found this information on the AMA website dealing with CPT codes (the AMA holds the copyright for CPT codes). I then did a search for "OMT" and came up with the codes as listed. I don't have the website reference since I am back at my away rotation today, and my printout is at home.

 

[Doctor Peloncito]

thats ok, thanks though

 

[Dr JPH]

Originally posted by (nicedream)
I realize this, but the fact is that the vast majority of DO's don't practice any OMM. Many complaints that patients present with could be ostensibly treated with OMM, often in conjunction with other treatments. Since a case could be made for the efficacy of OMM, and it pays well, I would think that more DO's would use it.

3 major reasons most DOs don't use OMM (as described by those DOs themselves):

1. Not sure how to get paid for it
2. Not sure they have enough time to do it
3. Not being confident or competent in OMM skills

Of course, if you are good at it, then it takes no time at all. I know DOs who can treat 9 body regions in minutes. Head to toe fixing fascial patterns, vertebral misalignment, sacral torsions and other things.

 

[docslytherin]

Originally posted by (nicedream)
I realize this, but the fact is that the vast majority of DO's don't practice any OMM.

i know that this is true but it seems so crazy to me since i'm in kirksville, mo right now. it seems like everyone is using omm (there are actually MDs in this town that perform omm sometimes).

i actually really like omm. i really didn't like it at all when i started school, but the more that i learn and the more i see it practiced, the better i enjoy it and understand it's value. omm has very really uses and very tangible benefits.

as to billing... like JP, i've seen clinicians treat multiple areas in a matter of minutes. it's amazing.

and to further toot JP's horn, i think he's right on with the reasons for others not doing omm. additionally, i think there are DOs out there who actually conciously avoid using omm because they don't want to appear different than an MD. it's really a tragedy. i have often heard students say that they'll not use omm because it's not what a "normal" doctor does.

 

[Dr JPH]

Originally posted by docslytherin
additionally, i think there are DOs out there who actually conciously avoid using omm because they don't want to appear different than an MD. it's really a tragedy. i have often heard students say that they'll not use omm because it's not what a "normal" doctor does.

Unfortunately this does seem to be true to some extent. The biggest killer of OMM, particularly in the inpatient setting, are DOs who don't use it and won't write for it for their patients or allow students (who are often more proficient in OMM than those docs themselves....ahem) to do it.

On the other hand, it seems that quite a few MDs are more than willing to let OMM be performed on their patients, so long as the student has a clear understanding of the science behind the technique and can offer valid information to the physician.

We (the collective DO community) are our own worst enemy.