Billing and Coding: Osteopathic Manipulative Treatment

Medicare covers osteopathic manipulative treatment (OMT) when medically necessary to treat documented somatic dysfunction, with required documentation of body regions treated, TART elements, and pre/post treatment status available upon request. Only one OMT service may be billed per day; E&M services are separately payable only when a significant, separately identifiable E&M is documented (use modifier 25), and frequencies generally follow acute (≈≤1/week), subacute (less frequent), and chronic (≈1–2/month) phase guidelines unless justified in the record.

"Osteopathic manipulative treatment (OMT) is covered when medically necessary to treat somatic dysfunction documented by examination findings describing pathology in skeletal, arthrodal, myofascial ..."

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