LABOR AND INDUSTRIES
Effective Date of Rule: July 1, 2008.
Purpose: Medical aid rules--Massage therapy maximum daily fees, WAC 296-23-250. 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.
Citation of Existing Rules Affected by this Order: Amending WAC 296-23-250.
Statutory Authority for Adoption: RCW 51.04.020(1) and 51.04.030.
Adopted under notice filed as WSR 08-05-103 on February 19, 2008.
Changes Other than Editing from Proposed to Adopted Version: Added language to specify the PT and OT WACs containing the maximum daily payments.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 1, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: April 22, 2008.
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 that may be found in WAC 296-23-220 and 296-23-230.
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.]