For Premium Assistance patients, coverage includes 10 treatments per calendar year. This is combined with chiropractic, physiotherapy, acupuncture, naturopathy and non-surgical podiatry. Treatment fees are to be paid by the patient at the time of the appointment, and reimbursed through MSP. MD referrals are not needed for Premium Assistance patients.
As of Jan 2012, ICBC now categorizes Massage Therapy as non discretionary Therapy as per Physiotherapy and Chiropractic. This means that treatment is automatically approved for a claimant injured in an MVA. A patient can seek and receive Massage Therapy any time after an MVA, provided that the claim is still open.
An MD referral is no longer necessary for the first 12 treatments. But the Therapist is required to assess and determine that their treatment plan is reasonable and necessary. ICBC is regulated to pay a portion of a minimum of 12 treatments, but as the discretion to authorize further Therapy (up to 20 treatments).
A request for more than 12 treatments is given if further Therapy is recommended by an MD, and again the treatments are deemed to be reasonable and necessary. All treatment fees are to be paid by the patient at the time of the appointment, and reimbursed through ICBC.
Fees Effective April 1, 2019, the provincial government updated the treatment fees that ICBC will cover for care and treatment after a crash. This has been outlined in the Insurance (Vehicle) Act and is highlighted in the table below.
|$107.00 (billable once)
|$80.00 + GST per treatment
|Pre-authorized numbers of treatments 12**
*These fees apply to all treatments administered on or after April 1, 2019, regardless of the date of the accident that caused the injury
**Within 12 weeks of the accident causing the injury Notes ICBC customers who choose to visit a health care provider that charges a higher rate than what ICBC funds under accident benefits (indicated above), will not be able to recover the user fees from ICBC for claims with a date of loss on or after April 1, 2019. This will mean that the patient is responsible for paying the user fee portion, which they may submit to their private health insurer for consideration of coverage. Treatments are based on sessions provided and fees reflect fair market rate for a standard industry visit. Treatment frequency will be based on clinical recommendations and should reflect best practice. However, multiple sessions provided by the same discipline, on the same day, will not be funded. In the case of a no-show, the clinic’s no-show and cancellation policies should apply. ICBC will not pay for no-show appointments.
Please check with your adjuster or lawyer regarding coverage and eligibility. If you have a lawyer, then a treatment authorization should be emailed to the clinic prior to your first appointment indicating the amount that will be covered.
Veteran’s Affairs require a medical referral for Massage Therapy. A Veteran may receive up to 15 visits per year, up to $110 plus GST. An increase can be applied for.
A doctor’s referral is required for us to bill DVA directly. Your Therapist will require a copy prior to your first appointment.
If a home visit is required call Blue Cross (1-866-811-6060 ext.4) BEFORE for eligibility for the travel expenses. A doctor referral is required for the Massage Therapy portion, as well as the “at home visit” portion of the service. This portion could take up to 2 weeks for Veterans Affairs to process this request. This needs to be done prior to your first visit. Veteran’s Affairs.
Each person has $4800 to spend in total, per calendar year, for all of their supplementary health benefits including Chiropractic, Physiotherapy, Massage Therapy and Acupuncture. This value does not include GST.
A physician referral is required prior to your appointment.
First Nations Health Care
First Nations Populations are billed through MSP the same way as those on premium assistance and they have the same allowance of coverage ($23/session for up to 10 overall treatments).
Treatment fees are to be paid by the patient at the time of the appointment, and reimbursed through MSP.
STAY TUNED FOR:
DIRECT BILLING with BLUE CROSS and PACIFIC BLUE CROSS plus more to come.