Oct. 21, 2024
Prospective patients will almost always ask if their laser therapy treatments will be covered by insurance. Do you know what to say?
You can find more information on our web, so please take a look.
Does insurance cover laser therapy?
This question actually has several answers in . Depending on your state and what type of provider you are, the answer could be yes. Note, however, that being able to bill for PBM does not necessarily mean you'll get paid!
We are focusing on healthcare scenarios in the USA for this post. International situations will vary. Contact us for additional resources. Nothing in this article is a replacement for competent legal advice; you must perform your own assessment with your legal team for your particular situation.
Provider type
MD, DO, NP, DDS, DMD, DC - can supervise and bill photobiomodulation in all 50 states
DPM, PT, OT, LAc, OD - can perform and bill photobiomodulation in most states with some restrictions
PA, LMT, LPN, RN, PTA, midwife, clinical psychologist, medical assistant - can perform PBM only under supervision in most states
Remember, ALL healthcare providers must stay within their scope of practice and follow all state and federal laws and board guidelines.
Insurance type - updated August
Medicare/Medicaid - policy now states this is a non-payable service
Private Insurance - a few plans will reimburse varying amounts for most providers
Personal Injury/Auto Accidents - most plans will reimburse most providers at 100%, at least for 6-12 sessions
Worker's Compensation - nearly every state is different!
Do you want to accept insurance?
For many healthcare providers, you may wonder if it's even worth billing insurance for laser therapy. Between visit limits, shrinking allowables, repetitive appeals, closing networks, pre-authorizations, and seemingly arbitrary payment determinations, there may be a lot of drawbacks. Of course, this might be offset by lowering the amount your patients are responsible for, and the subsequent increased volume you might sustain.
Some providers may choose to stay out of network yet bill for light therapy, but this practice can still result in limited collections and increased patient portions.
If you're going to provide light therapy in a self-pay model, you'll need to determine a proper fee schedule with any discounts you want to provide. Check out our done-for-you FREE calculator that ensures you're charging enough to cover your costs and ensure a profit.
What do you tell patients who ask, "is laser therapy covered by insurance?"
If you don't accept insurance, you don't want to go straight to "no" as your answer. That shuts down further discussion and may prevent that patient from getting the care they need. If you don't take insurance, in many cases your rates may be less than or about the same as the patient's co-pay/co-insurance (especially considering deductibles and visit limits). Instead of "no," a better response might be:
What insurance plan do you have? (PI cases often pay for laser)
Easetak are exported all over the world and different industries with quality first. Our belief is to provide our customers with more and better high value-added products. Let's create a better future together.
What's your copay? (your charge for laser therapy may be less than a regular copay)
Have you met your deductible? (often an expense patients overlook, but might mean they would be self-pay anyway)
The goal is never to be deceptive, but simply to get the conversation rolling. This will give you more insight to the patient's situation and allow you to talk with them about your discounts.
If you do accept insurance, make sure you don't give a blanket "yes." Just accepting insurance does not mean that their plan will pay your fees. Always let the patient know that you'll need to verify their benefits to know what the insurance MIGHT pay. There's never a guarantee that the patient won't be left holding the bag.
What should I charge for laser therapy?
This is a super common question and the answer is pretty complicated. There are a lot of factors to consider when you're pricing photobiomodulation treatments. You have to earn a good ROI, pay your staff, and be compensated for your expertise. There's a lot to consider here, which is why we built a NEW free return on investment calculation tool with our decades of clinical and business experience. Simply fill out the form to get a personalized pricing assessment and so much more.
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Here at Borja PT, our world revolves around our patients&#; needs! Our highly trained and experienced team is here to make your recovery a reachable goal! We specialize in keeping you active. By doing so, we empower your decision to heal the natural way, without relying on pain pills, injections or surgery. That&#;s where laser therapy comes in. Its revolutionary science has been helping millions of people across the world achieve the pain relief they&#;ve been dreaming of. So, let&#;s take a closer look at laser therapy and answer some of your burning questions, like what are the different types of lasers, how many treatments do you need, and will insurance cover laser therapy treatments?
First, let&#;s talk about what laser therapy is and how it works.
Laser therapy is a safe and effective way to eliminate pain and speed up your body&#;s ability to heal. It uses a special light to target injured areas, without being invasive like injections or surgeries. Treatments are quick and painless. You&#;ll leave each session in less pain than you did when you arrived, making it easier to get back to your normal tasks and activities.
Laser therapy works on a cellular level. As your cells absorb the light, the damaged ones become supercharged and start a chain reaction of positive changes throughout your body. As a result, your natural healing processes speed up, allowing you to get out of pain and move easier than before.
One of the best parts about laser therapy is that treatment isn&#;t invasive. Not to mention, it&#;s safe, fast, and painless. You can get treatment directly on the skin or about a half inch above the area, depending on the injury. While all injuries are different, most people see results within as little as 3 to 5 sessions. Better yet, the effects of the laser continue up to 18 hours after treatment. This means you&#;ll heal throughout your day, long after your treatment.
Laser therapy can treat conditions like:
Laser therapy also helps with post-surgical recovery. In fact, in some cases, it can prevent surgery altogether.
There are 4 different classes of lasers. They&#;re divided based on their power, with class I being the lowest and class IV being the highest. Unfortunately, most lasers aren&#;t covered by insurance, but a few lower class lasers are. More on that later&#;
Class II and III lasers are called low level lasers. These lasers work on the surface of your skin without causing a flush of heat. Since they&#;re limited in power, they only deliver a small amount of photons to damaged cells, which has less of an impact on injuries. So, they can still benefit less dense areas, but it will take much longer to be effective.
Class IV lasers, on the other hand, are the most powerful medical lasers available. They go beyond the surface of your skin, traveling through muscles, joints, and even bones. Class IV lasers deliver powerful doses of light at a specific wavelength in a small amount of time. This means your treatment is short and effective, saving you both time and money. Talk about a win-win.
When you&#;re injured or in pain, there are a ton of treatment options available. Two of the most popular choices are acupuncture and massage therapy, which works on top of your skin. Laser therapy, on the other hand, penetrates deep in your body. The light is so effective, it can travel through muscles, bones, and joints. So, while those treatments can be helpful, laser therapy takes your healing to the next level.
Laser therapy doesn&#;t act as a temporary fix, it actually causes a series of changes that allows your body to heal itself. Essentially, lasers impact how your cells function. When your damaged cells absorb the light, they get flooded by photonic energy and begin repairing themselves from the inside out. If that isn&#;t enough, studies show that impaired cells actually have a stronger response to the light than healthy cells do.
Simply put, it&#;s the science behind laser therapy that makes it such an advantageous treatment option. You aren&#;t just placing a band-aid over your symptoms, you&#;re healing them directly at the source.
Another benefit to laser therapy is that it can accelerate your healing.
Treating your injury is a journey. There needs to be a balance between where you are in the recovery process and how much pain you&#;re experiencing, all while slowly increasing your activities accordingly.
Typically, most treatment plans first aim to reduce pain and inflammation by using modalities like ultrasound and electrical stimulation, then shift to restoring range of motion and function later on. In these situations, relief isn&#;t immediate since the focus is solely on masking symptoms. The only true way to effectively reduce your pain is to address the root of the problem.
When you use laser therapy alongside modalities, you don&#;t have to choose between reducing pain symptoms and restoring function and range of motion. Working on all areas of recovery at the same time allows you to get out of pain and return to daily living faster than ever.
As previously mentioned, there are some insurance companies that cover low level laser therapy. Hospitals and inpatient facilities have been using these lasers for years to safely treat patients with a range of conditions. Unfortunately, because the lasers are less powerful, they have significantly lower results, often leaving people feeling disappointed.
Here at Borja PT, we use the class IV Lightforce FXi Laser. It&#;s an excellent way to relieve pain without relying on surgery or prescription meds. Whether you&#;ve had pain for just a few days or for several months, laser therapy can help.
Currently, insurance does not yet cover class IV laser therapy. However, more and more companies are beginning to see the benefits of laser therapy and move toward possibly making it a covered benefit down the road.
In the meantime, we offer several laser therapy packages.
You can choose to purchase individual laser therapy treatments, or bundle them for higher savings. The number of sessions you&#;ll need in your road to recovery all depends on your condition.
At your first treatment, we will evaluate your injury and determine the protocol that would be most beneficial to you. This is what we like to call the induction phase. After your 4th session, we&#;ll reassess your injury to see how you&#;re responding to the protocol and if any modifications are needed.
The next phase depends on how much progress you&#;ve made. For newer injuries, you may only need a few more laser treatments. Older injuries, on the other hand, may need another 6-12 sessions. Remember, the longer you&#;ve been in pain, the more treatment you may need to heal.
Laser is often used with other kinds of therapy, especially physical therapy. In fact, many people have the best results when they combine both types of therapy. Think of it as working double to recover and get back to enjoying the things you love. We offer discounts for those who do both PT and laser together.
PT focuses on controlling pain and improving function. This is done by strengthening muscle groups that are responsible for stability. Using laser to speed up your healing can help reach this goal.
For example, some of the benefits of using laser and PT together include:
Click here to learn more about our LightForce Laser service or click here to learn about using laser and PT together.
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If you want to learn more, please visit our website Low-Level Laser Therapy for Menstrual Pains.
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