What is Super Billing?
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A superbill is a statement of services provided by me the therapist which you the patient are able to submit to your insurance carrier for reimbursement. This allows you to utilize the insurance you already pay for and decrease your cost of seeing Mama Bee OT as an out of network provider
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All services will be determined based on the types of activities are performed in each session. these activites are broken down into Current Procedural Terminology (CPT) codes. I use most commonly include:
97112 Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities
97110 Therapeutic exercises that a patient participates in during an OT therapy session. These exercises help build strength or endurance to support a return to normal functioning.
97140 Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction) 1 or more regions, each 15 minutes
97150 Therapeutic procedure(s), group (2 or more). It is important to note that group therapy is not based on time and is reported for each member of the group)
97530 Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes
97633 Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes
97535 Self-care/home management training (e.g., activities of daily living [ADLs] and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment), direct one-on-one contact, each 15 minutes97537 Community/work reintegration training (e.g., shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes
CPT CODE 97165 Occupational therapy evaluation, low complexity
CPT CODE 97166 Occupational therapy evaluation, moderate complexity
CPT CODE 97167 Occupational therapy evaluation, high complexity
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Each policy is different, and each carrier will have different policies on what is needed to submit out of network claims, some companies also require a referral or prescription for therapy from your doctor.
As a patient you will need to call your insurance company to ask if there are any pre-authorized requirement to submit out of network claims for Occupational Therapy.
You can also verify your coverage benefits and ask for assistance in determining your out of network cost for sessions. Some providers may reimburse different rates for different CPT codes, you can ask for this information and give the codes listed above.
Looking for more?
Group Booking option:
Intended for up to 6 people/mom & baby pairs. In-Home or Host location available at The Hangout Libertyville
Booking feature coming soon! Please book as (Cash rate visit and indicate in the reason for visit what your group intends for time)