Resource - How to Get Paid for Doing OMM
As a DO, regardless of your specialty, you can use OMM in your office visits AND bill for it!
First thing's first: Do OMM because of all the benefits it provides to your patients and their health. If you're doing this for the money, you're in the wrong profession.
Now, with the most important part out of the way, let's talk business:
There seems to be a common misconception among medical students that OMM is too time consuming and/or physicians won't get paid for it. This couldn't be farther from the truth! By including even a few minutes of (indicated) Osteopathic treatment in your regular exam, you can easily increase your billing for that visit by over 50%.
Want to see how that works?
Let's take a look at a grossly oversimplified version, using some 2007 figures from Missouri. Please note, while these numbers were close estimates at the time this was written, they change all the time. This is more just to give you an idea of the process rather than any specifics.
| Code | Name | Medicare | Unicare/ Healthlink | BCBS of MO | United |
| First, Bill for the Office Visit | |||||
| 99203 | New Pat. Office Visit | 83.24 | 120.41 | 99 | |
| 99213 | Est. Pat Office Visit | 54.06 | 66.33 | 54 | |
| Then, add on the OMM as a Procedure | |||||
| 98925 | OMM 1-2 Areas | 25.26 | 38.73 | 39.00 | |
| 98926 | OMM 3-4 Areas | 35.15 | 54.12 | 54.00 | 52.98 |
| 98927 | OMM 5-6 Areas | 45.47 | 68.00 | 67.00 | |
| increases up to 10 areas, as reimbursements increase as well | |||||
Using the chart above, let's say you bill for an average new patient office visit. Alone, you can bill Medicare for $83.24 (#99203). Let's say you do 1-2 areas of OMM as a procedure in addition to your office visit -- now, using the scenario above, you can bill Medicare for the office visit we already mentioned ($83.24) AND 1-2 areas of OMM at $25.26, for a total of $108.50 instead of the original $83.24. This is easy to work into the time you already spend doing your exam and make the patient feel better.
Notice the changes across the chart- OMM is billed per the number of body areas treated. There is also some difference on how much you might get reimbursed based on what insurance the patient has, the state your in, how you chart, insurance-specific guidelines, etc. The chart above just features a few values for demonstration purposes - the real coding system goes on for pages and pages! This example isn't about getting into the legalities of billing and charting or the specifics for your state -- it's about showing you that insurance WILL regularly reimburse for OMM. Docs who think they won't get paid for OMM just need to learn to do the billing correctly!
Check out https://www.cms.hhs.gov/PhysicianFeeSched for more specific info on Medicare Fee Schedules.
Final Ethical side note: Don't let the cash guide your desire to practice medicine, or you'll lose the healing tenets upon which Osteopathy and all effective healing should be practiced. Just use this information to know that the skills you're learning aren't just valuable to your patients, but they're also valuable to maintaining your practice.
Now, aren't you glad you went to DO school?