Clinicians rarely get into their profession to make large amounts of money. Most do what they do because they love to help people. Unfortunately, patients don’t get helped if clinics can’t make enough money to keep the doors open, so we have to consider the financial aspect of any treatment tool.
Overall, red light therapy offers a great opportunity for improved patient care, which “big picture” clinicians will recognize as the key to increased referrals and long-term financial stability. Here are some considerations as we look deeper into the financial implications of red light therapy.
Billing Codes
While many clinics have moved to a cash-based model, the majority of therapy clinics in the US are still insurance-based providers. Proper coding and billing is vital for these clinics to survive.
Here are a few suggested codes that can be utilized for red light therapy. Keep in mind that laws vary state by state and by profession, so do your own research when considering billing for red light therapy or any new tool or modality.
97026 — Attended Infrared light therapy. This code is intended for older style heat lamp type infrared therapy; thus reimbursement can be a challenge at times with this code.
97032 - Attended electronic photonic stimulation per 15-minute increment.
97039 - Unlisted modality with constant attendance: Attended laser therapy. The unlisted nature of the code can result in rejection.
97112 - Neuromuscular reeducation with laser therapy per 15-minute increment.
Cash
As mentioned above, cash-based clinics are more popular than ever. It doesn’t work for everyone, but for a section of our population, cash practices offer a lot of advantages to both patients and clinicians.
Cash-based practices typically make it easier to add new services and charges. Red light therapy can be offered as part of a package or hourly rate. When patients enter a cash-based practice, they typically expect to be able to pick and choose what they want for their care.
Many insurance-based clinics offer cash pay options for poorly reimbursed services such as dry needling or kinesiology tape and red light therapy can fit into that model, if the clinic wants to pursue it as an add on cash sale.
Retail
Retailing product is a great way to improve patient outcomes, increase patient satisfaction, and generate revenue. As a patient’s medical provider, the clinician usually becomes a trusted source for information. When a patient finds that they like a specific treatment or tool, many times they want to purchase one for themselves. This is a great opportunity to offer a trusted product to them on the spot, rather than asking them to search online or at a store for a similar product. Also, many patients only make it into the clinic a few times per week, making home treatments options a great opportunity to get work done in between therapy sessions. Encouraging them to use red light therapy at home will result in better outcomes. Retailing red light therapy wraps in the clinic is a win for everyone involved.
Part of Service
The easiest way to integrate red light therapy into a clinical practice is to streamline it into the normal flow of the clinic. This is easily done by replacing hot packs and ice packs with red light therapy. Photobiomodulation will have similar pain-relieving effects as either tool, but with better tissue healing properties. Keep in mind that neither heat or
ice are reimbursed by insurance companies, so even if you don’t have success with insurance providers paying on red light therapy, the clinic is no worse off financially and the patient outcomes will certainly improve.
Including red light therapy within the overall service of the clinic is the easiest and most efficient way to use red light therapy. Whether or not that results in increased direct revenue to the clinic is debatable, but what is certain is that there will be an improvement in pain, healing, inflammation and performance. Quality care always results in increased referrals by physicians, family members and friends.
Conclusion
Every clinic has their own strategies for monetizing their services to ensure the long-term success of the practice. Red light therapy can be used and billed in a variety of ways to not only improve patient outcomes but ensure the financial stability of the clinic.
