ICBC Coverage for Massage Therapy in BC

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ICBC Coverage for Massage Therapy in BC

ICBC
Until recently, coverage for patient's seeking massage therapy after an MVA (Motor Vehicle Accident) was limited by ICBC to a maximum of 12 treatments over an 8 week period starting from the date of the accident. After this coverage had run out, ICBC would not accept any applications for extended coverage even if both the patient's RMT and MD agreed it was indicated. Subsequent to the Raguin vs. ICBC court decision in November 2011, ICBC implemented new coverage for massage therapy treatments. The first six items (below in bold) reflect this new coverage.
 
ICBC - Current Massage Therapy Policy as of January 2012
For RMTs Registered as ICBC Providers - New Items in Bold
  • ICBC now categorizes massage therapy as nondiscretionary therapy as per physiotherapy and chiropractic. This means that treatment is automatically approved for a claimant injured in an MVA
  • ICBC has removed the "1st 8 week post MVA" time limitation on massage therapy treatments. This means that a patient can seek and receive massage therapy any time after an MVA, provided that the claim is still open.
  • An MD referral is no longer necessary for the first 12 treatments. But all therapists are required to assess and determine that their treatment plan (as per CMTBC practice standards) is reasonable and necessary.
  • The MTABC encourages RMTs to contact the ICBC adjuster to advise of the therapy being provided.
  • ICBC is regulated to pay a minimum 12 treatments but has the discretion to authorize further therapy (up to 20 treatments). A request for more than 12 treatments is given if further therapy is recommended by an MD, and again the treatments are deemed to be reasonable and necessary.
  • The MTABC encourages RMTs to base their treatment plans on the best available research evidence, clinical reasoning and patient values.

  • RMTs have the choice of accepting the terms of the ICBC Provider Status.
  • If an RMT applies for and accepts an ICBC Provider Number then the RMT is expected to follow the provisions and terms of the ICBC agreement. This includes billing at ICBC rates of $23.00 plus HST (for a total of $25.76). It's always $23.00, even for initial treatments
  • If an RMT chooses not to have an ICBC Provider Number then RMT can bill at their professional rates and the claimants will submit to ICBC to have the $23.00 reimbursed.
  • The patient must be aware and accept the terms of the ICBC RMT fee schedule and treatment plan prior to treatment.
  • ICBC may reimburse the BI claimants at time of settlement for medical expenses including medically referred massage therapy treatments.
  • If the patient has extended benefits, two receipts may be written: one for $23.00 to be submitted to ICBC and another for the remaining to be submitted to their private insurance company.
Source: MTABC (Massage Therapists Association of BC)
 
 
 
 
 
 
 
 
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