Understanding Your Insurance
HighMark BCBS NE NY
HighMark BCBS NE NY plan GQX
We are practicing providers with HighMark BCBS NE NY.
You will see us as a provider in the healthcare system however, the ONLY PLAN that pays for massage therapy (97124) by a Licensed Massage Therapist is plan prefix GQX. **
All other plans have massage therapy available by a Physical Therapist as we bill the same CPT code.
Please understand that we only accept plans with the prefix GQX as this plan will pay for massage therapy by a Licensed Massage Therapist.
If you have any questions please feel free to email or call the office for clarity before trying to book your appointment.
Medicare Advantage Massage Therapy Receipt Reimbursement
Medicare Advantage, also called Medicare Part C, is a private insurance option approved by Medicare that serves as an alternative to original Medicare.
These plans provide all the benefits of Part A (hospital insurance) and Part B (medical insurance) and often include additional coverage for services like vision, dental and wellness programs. Most Medicare Advantage plans also offer prescription drug coverage (Part D).
With a focus on a more holistic approach to healthcare, these plans frequently tailor their benefits to meet the diverse needs of their members, which can include support for pain management and wellness services.
Medicare Advantage plans operate through networks of healthcare providers, and enrollees typically need to follow specific rules regarding where and how they receive care.
While original Medicare does not cover massage therapy, some Medicare Advantage plans may offer it as part of their expanded benefits. This coverage is typically included under wellness or complementary therapy options, recognizing the role of massage therapy in managing chronic and acute pain, reducing stress, and improving overall health.
Coverage details, such as the conditions eligible for massage therapy, the number of sessions allowed and reimbursement policies, vary by plan. Massage therapy clients should check with their specific Medicare Advantage provider to understand the scope of their benefits, including any referral or pre-authorization requirements.
