Blue cross blue shield of Minnesota: missing the forest for the trees.
Year: 2008
Type: article
Abstract: On September 29th, Blue Cross and Blue Shield (BCBS) of Minnesota issued a bulletin stating that manual therapy and massage codes (97140 and 97124 respectively) would no longer be covered as of January 1, 2009. As a student in a doctoral program that strongly endorses the use of evidence-based interventions, this policy is short-sighted and could indirectly promote interventions that lack credible evidence. Manual therapy is heavily supported in the literature as a successful intervention for the spine1,2, headaches3, neck4,5, and shoulder6. Unwillingness to reimburse these codes, specifically 97140, implies that BCBS of Minnesota is either uninformed, or that they do not care for the well being of their insured.
There is information that this policy may be reactionary effort to curb inappropriate use of these codes by practitioners other than physical therapists. Indeed, if fraud or inappropriate use is prevalent, the answer is enforcement; not punishing the insured and other healthcare providers such as physical therapists, who provide these interventions in an appropriate manner. This thoughtless action by BCBS of Minnesota has the potential to undermine our professional stance as advocates of evidence based care.
I understand that the Minnesota Physical Therapy Chapter is working diligently to arrive at a constructive solution to this situation. As a physical therapists community, we should support their efforts in every possible way. We cannot afford, economically or politically, to allow BCBS of Minnesota to institute a policy that restricts physical therapy practice by eliminating reimbursement for the use of manual therapy and massage interventions. As a profession, we can't miss the forest for the trees: even if BCBS of Minnesota elects to do so.
Source: PubMed
Author: Brian Neville
Institution: Duke University
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W23680582