--- title: Insurance billing checklist for massage therapy and mobile practices description: "A step-by-step checklist for massage therapy and home-visit practices: set up Claim.MD, payers, timed codes and place of service before your first claim." --- [Skip to content](https://support.pabau.com/en/pabau2/insurance-billing-checklist-for-massage-therapy-and-mobile-practices#main-content) [![pabau logo white](https://support.pabau.com/hubfs/pabau%20logo%20white.svg)](https://support.pabau.com/en/pabau2?hsLang=en) Open main navigation Close main navigation - [Get Support](https://pabau.com/support-center/) [Get Support](https://pabau.com/support-center/) Pabau Knowledge Base - There are no suggestions because the search field is empty. 1. [Pabau Knowledge Base](https://support.pabau.com/en/pabau2?hsLang=en) 2. [Insurance Billing](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en) 3. [Insurance Billing (US)](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en#insurance-billing-us) # Insurance billing checklist for massage therapy and mobile practices Massage therapists and practices that travel to their clients have a few billing details that office-based practices rarely meet: timed codes billed in 15-minute units, a place of service of the client’s home, and payers such as Medicaid plans that assign their own IDs and local codes. This checklist takes you through everything to set up before your first claim, and the routine for each visit. Each step links to a detailed guide. **NOTE:** Insurance billing is currently available for practices in the United States. Claims are submitted electronically through the Claim.MD clearinghouse. You need administrator access for the setup steps. **Step 1: Check the Claim.MD Setup Checklist** Go to **Setup → Claims** and open **Claim.MD**. If you have not connected your Claim.MD account yet, start with [Insurance Guide Part 1](https://support.pabau.com/en/pabau2/insurance-guide-part-1-set-up-the-insurance-essentials-in-pabau?hsLang=en). Then, on the **Overview** tab: 1. Check that each row shows **Done**. A row marked **To do** still needs work. Click it to open the tab where you finish it. 2. Use the tabs on the left to work through **Credentials**, **Billing profile**, **Providers** and **Payers**. Steps 2 to 5 below cover what to check on each. ![The Claim.MD Overview tab shows what is done and what is still to do](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489459989740-01-overview.png) *The Claim.MD Overview tab shows what is done and what is still to do* **Step 2: Turn Off Transmit Approval in Claim.MD** Claim.MD can hold every claim you send until someone approves it in the Claim.MD portal. Pabau cannot release a held claim, so turn this off before you start. Select the **Credentials** tab and scroll to **Claim.MD account settings**. Then: 1. Click **Open Claim.MD**, go to **Settings → Account Settings** in the Claim.MD portal and turn off **Require approval before transmit**. 2. Back in Pabau, set **Transmit Approval Required** to **Off**. Record the other three settings as you find them in the portal. 3. Click **Save settings**. Next time you check and nothing has changed, click **Confirm still current** instead. ![Record your Claim.MD account settings on the Credentials tab](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489459989740-02-account-settings.png) *Record your Claim.MD account settings on the Credentials tab* **Step 3: Check Your Billing Profile** On the **Billing profile** tab, check the details that identify your practice on every claim: - **Billing provider name**, **Billing provider NPI** and **Tax ID (9 digits)** exactly as you are enrolled with your payers. A small difference, such as a missing “LLC”, can get claims rejected. - **Billing taxonomy**: for massage therapy this is usually 225700000X. - **Default place of service (box 24B)**: if most of your visits are in the client’s home, choose **Patient home (12)**. See [How to set the place of service for home visits, mobile and telehealth claims](https://support.pabau.com/en/pabau2/how-to-set-the-place-of-service-for-home-visits-mobile-and-telehealth?hsLang=en). **TIP:** **Mobile unit (15)** is for care given in a vehicle fitted out as a clinic. When you travel to the client’s home with a portable table, use **Patient home (12)**. **Step 4: Add Each Practitioner’s NPI** On the **Providers** tab, every practitioner who treats insured clients needs their own individual NPI as their rendering provider. If a payer gave a practitioner their own provider ID, which many Medicaid plans do, add it for that payer only. See [How to set rendering and billing provider details for each practitioner](https://support.pabau.com/en/pabau2/how-to-set-rendering-and-billing-provider-details-for-each-practitioner?hsLang=en). **Step 5: Set Up and Enroll Each Payer** On the **Payers** tab, link every insurer you bill to its Claim.MD payer, then enroll with each payer for claim filing and ERA payment reports. See [Electronic enrollments with insurance payers](https://support.pabau.com/en/pabau2/electronic-enrollments-with-insurance-payers?hsLang=en). Then check each insurer’s own settings. Go to **Setup → Third Parties**, click the insurer and select the **Settings** tab: 1. Set **Insurance program** to the type of plan, such as **Medicaid**, **Commercial Insurance Co** or **Workers Compensation Health Claim**. It sets the insurance type on printed CMS-1500 claims, and with a workers’ compensation program, new claims start with the treatment note ticked to send. For work injuries, see [How to bill workers’ compensation, FECA and Black Lung claims](https://support.pabau.com/en/pabau2/how-to-bill-workers-compensation-feca-and-black-lung-claims?hsLang=en). 2. Check that **Payer ID** shows the Claim.MD payer. Use **Find a Claim.MD payer** to link it if it is empty. 3. If the plan gave your practice its own provider number, enter it in **Billing provider ID for this insurer** (box 33b). Medicaid plans often do this. ![An insurer’s claim settings](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/489459989740-03-insurer-settings.png) *An insurer’s claim settings* Click **Save**. **Step 6: Code Your Services** In **Setup → Services**, give each insured service its billing code on the **Pricing** tab: - Add the CPT code, for example **97124** for massage therapy, and set its **Default units**. A 60-minute massage billed in 15-minute units is 4 units. See [How to bill timed codes in units (such as 15-minute massage codes)](https://support.pabau.com/en/pabau2/how-to-bill-timed-codes-in-units?hsLang=en). - If one service is always given somewhere other than your practice default, for example a home visit when most visits are in your office, set its **Place of service**. - If a payer uses its own local codes, add them first as custom codes. See [How to add your own billing codes, such as Medicaid local codes](https://support.pabau.com/en/pabau2/how-to-add-your-own-billing-codes-such-as-medicaid-local-codes?hsLang=en). **Step 7: Price Each Unit** In **Setup → Price Lists**, open each insurer’s price list and enter its rate for one unit of each service, not the price of the whole visit. Pabau multiplies the rate by the units on the invoice. **Step 8: Set Up Each Insured Client** On the client’s **Insurance** tab, add their policy (see [Insurance Guide Part 2](https://support.pabau.com/en/pabau2/insurance-guide-part-2-client-insurance-setup-in-pabau?hsLang=en)). Then: - Record their signed authorizations and any referring provider on the policy. Plans that need a prescription for massage therapy usually want the prescribing provider on the claim. See [How to set claim defaults on a client’s insurance policy](https://support.pabau.com/en/pabau2/how-to-set-claim-defaults-on-a-clients-insurance-policy?hsLang=en). - If the plan authorized specific codes, units and diagnoses, add them to the policy as default billing codes. See [How to add default billing codes to a client’s insurance policy](https://support.pabau.com/en/pabau2/how-to-add-default-billing-codes-to-a-clients-insurance-policy?hsLang=en). - If the plan gave you a prior authorization, add a case for it with its **Auth code** and **Maximum number of services**, so the number goes on each claim (box 23) and Pabau counts the visits used. **For Every Visit** 1. Book the appointment charged to the client’s insurer, with the authorization case if there is one. See [Insurance Guide Part 3](https://support.pabau.com/en/pabau2/insurance-guide-part-3-connect-appointments-to-insurance-in-pabau?hsLang=en). 2. After the visit, raise the invoice to the insurer. If the visit ran shorter or longer, change the **Billing units**. 3. Open the claim from **More → Claims**. Check the code, units, place of service and diagnosis, then click **Validate**. 4. If the payer wants the treatment note, attach it. See [How to send a chart note or other document with a claim](https://support.pabau.com/en/pabau2/how-to-send-a-chart-note-or-other-document-with-a-claim?hsLang=en). 5. Send the claim, then work through the status folders on the claims list. See [Understanding claim statuses on the Insurance claims list](https://support.pabau.com/en/pabau2/understanding-claim-statuses-on-the-insurance-claims-list?hsLang=en). 6. When a payer sends a paper EOB instead of an ERA, record it on the claim. See [How to record a payer payment or denial from a paper EOB](https://support.pabau.com/en/pabau2/how-to-record-a-payer-payment-or-denial-from-a-paper-eob?hsLang=en). For out-of-network clients who pay you themselves, download a superbill from the invoice instead, so they can claim the money back from their insurer. See [How to download a superbill for a client](https://support.pabau.com/en/pabau2/how-to-download-a-superbill-for-a-client?hsLang=en). **IMPORTANT:** Timed codes count only the time you spend treating the client. Travel to and from a home visit does not count toward the units. **What's next?** - [Insurance Guide Part 1: Set up the insurance essentials in Pabau](https://support.pabau.com/en/pabau2/insurance-guide-part-1-set-up-the-insurance-essentials-in-pabau?hsLang=en) - [How to bill timed codes in units (such as 15-minute massage codes)](https://support.pabau.com/en/pabau2/how-to-bill-timed-codes-in-units?hsLang=en) - [How to set the place of service for home visits, mobile and telehealth claims](https://support.pabau.com/en/pabau2/how-to-set-the-place-of-service-for-home-visits-mobile-and-telehealth?hsLang=en) - [Insurance Guide Part 4: Submit and track insurance claims in Pabau](https://support.pabau.com/en/pabau2/insurance-guide-part-4-submit-and-track-insurance-claims-in-pabau?hsLang=en) --- Was this guide helpful? Let us know by voting below - your feedback helps us write clearer articles. 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