billing for services not typical to a profession

[richw]

Assuming state scope of practice allows, can private insurance be billed
a) by a medical doctor for CMT or OMT?
b) by a naturopath for CMT or OMT?
c) by a chiropractor for OMT?
d) by an osteopath for CMT?

Thanks!

[Michele]

Not sure if I fully understand but you can bill the private insurance, it's a matter of if they cover it.  From my experience and MD cannot bill for CMT or OMT, most naturopaths are not credentialed by insurance, DCs cannot bill OMT and osteopaths would bill using OMT codes not CMT.

Hope that helps!

[richw]

Maybe it depends on location. I’ve read on another billing forum of an MD billing for CMT. In Alaska naturopaths are licensed and credentialed with major insurances and are trained in manipulation, so I assume they can bill for it.

[Michele]

I think it might also vary by health plan as well.  I've seen some that have very rigid lines as to what a provider can bill for as "in their scope of practice".