Original Notice.

     Preproposal statement of inquiry was filed as WSR 08-01-111.

     Title of Rule and Other Identifying Information: Medical aid rules -- Massage therapy maximum daily fees, WAC 296-23-250.

     Hearing Location(s): Department of Labor and Industries, 7273 Linderson Way S.W., Tumwater, WA 98501, on March 26, 2008, at 1:00 p.m.

     Date of Intended Adoption: April 22, 2008.

     Submit Written Comments to: Tom Davis, P.O. Box 44322, Olympia, WA 98504-4322, e-mail dato235@LNI.wa.gov, fax (360) 902-4249, by April 2, 2008.

     Assistance for Persons with Disabilities: Contact Tom Davis by March 19, 2008, TTY (360) 902-5797 or fax (360) 902-4249.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of the rule is to update the department's payment rates for health care services by setting the maximum daily payment level for massage therapy services to 75% of the PT/OT cap.

     Reasons Supporting Proposal: This rule will provide medical aid updates regarding rate setting for massage therapy services for injured workers.

     Statutory Authority for Adoption: RCW 51.04.020(1) and 51.04.030.

     Statute Being Implemented: RCW 51.36.080.

     Rule is not necessitated by federal law, federal or state court decision.

     Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: The proposed rate change is expected to reduce the department's liability by approximately $800,000 in fiscal year 2009.

     Name of Proponent: Department of labor and industries.

     Name of Agency Personnel Responsible for Drafting: Tom Davis, Tumwater, Washington, (360) 902-6687; Implementation and Enforcement: Robert Malooly, Assistant Director, Tumwater, Washington, (360) 902-4209.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. This rule adoption is exempt under RCW 34.05.328 (5)(b)(vi) and 19.85.025(3).

     A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply because the content of this rule is explicitly dictated by statute and fits within the exceptions listed in RCW 34.05.328 (5)(b)(vi).

February 19, 2008

Judy Schurke

Director

OTS-1313.1

AMENDATORY SECTION(Amending WSR 05-18-030, filed 8/30/05, effective 10/1/05)

WAC 296-23-250   Massage therapy rules.   Practitioners should refer to WAC 296-20-010 through 296-20-125 for general information and rules pertaining to the care of workers. See WAC 296-20-125 for billing instructions.

     Refer to WAC 296-20-132 and 296-20-135 for information regarding use of the conversion factors.

     Massage therapy treatment will be permitted when given by a licensed massage practitioner only upon written orders from the worker's attending doctor. In addition, physician assistants may order massage therapy under these rules for the attending doctor.

     A progress report must be submitted to the attending doctor and the department or the self-insurer following six treatment visits or one month, whichever comes first. Massage therapy treatment beyond the initial six treatments will be authorized only upon substantiation of improvement in the worker's condition in terms of functional modalities, i.e., range of motion; sitting and standing tolerance; reduction in medication; etc. In addition, an outline of the proposed treatment program, the expected restoration goals, and the expected length of treatment will be required.

     Massage therapy in the home and/or places other than the practitioners usual and customary business facilities will be allowed only upon prior justification and authorization by the department or self-insurer.

     No inpatient massage therapy treatment will be allowed when such treatment constitutes the only or major treatment received by the worker. See WAC 296-20-030 for further information.

     Massage therapy treatments exceeding once per day must be justified by attending doctor.

     Maximum daily reimbursement levels for massage therapy are seventy-five percent of the maximum daily reimbursement levels for physical and occupational therapy services.

     Billing codes, reimbursement levels, and supporting policies for massage therapy services are listed in the fee schedules.

[Statutory Authority: RCW 51.04.020 and 51.04.030. 05-18-030, § 296-23-250, filed 8/30/05, effective 10/1/05. Statutory Authority: RCW 51.04.020, 51.04.030 and 1993 c 159. 93-16-072, § 296-23-250, filed 8/1/93, effective 9/1/93.]

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