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mcone
114 Posts |
 Posted - 10/21/2008 : 11:31:57
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Can psychotherapy to treat a TMS pain syndrome be submitted to insurance as some kind of "medical" or "physical" service (as opposed to a mental health service)?
My insurance has limits on the # of psychotherapy visits I can get, and I'm approaching the limit.
Can anyone think of a way to have TMS therapy billed or coded to a medical category? Thanks! |
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winnieboo
USA
269 Posts |
Posted - 10/21/2008 : 11:53:02
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There are certain psychological disorders that are considered "biological," and many insurance companies will reimburse on an unlimited basis for these certain, biological disorders (after you have met a deductible and other requirements, of course). Check with your particular company.
For example, my company considers OCD a biological disorder (along with Major Depression et al.,) and since TMS has some obsessive qualities, my therapist assigned an OCD diagnosis to me. (Besides TMS, however, I do have other manifestations of OCD as well.) The company reimburses up to the full allowable amount for this, with no limit per year on visits. So see what makes sense in your situation, if anything. Good luck. |
Edited by - winnieboo on 10/21/2008 16:26:50 |
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mcone
114 Posts |
Posted - 10/23/2008 : 22:56:28
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Thanks for the reply WB. I have to agree with you that it isn't a stretch to characterize many psychological disorders as biological - and insurance companies should be expected to honor claims accordingly.
Of course, TMS sort of turns this idea on it's head - by treating as psychological many issues convention medicine thinks of as physical. The lines are so blurred for me (and I guess many of us) at this point - especially with acceptance that the psychological drives the physiological - a relationship and an interaction that isn't well understood. And I'm learning that this needs to be accepted too.
Interestly, Congress recently passed a mental health parity bill, to be effective in early 2010, that will require insurers to cover mental health care to the same extent as "medical" care. A step in the right direction.
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Insurance
