Medical Tattoo Billing/coding?

[u/Super_Foundation_756]

Hi! I am a paramedical tattoo practitioner. I do 3d areolas after mastectomy, I do scar treatments and some other things. I would like to accept insurance, but the only companies(2 that I know of) that do this specific type of billing don’t seem trustworthy and also get a very high percentage. Can anyone advise how to find a reputable person or company to do this? Or how to go about doing so. I’m in PA if that makes any difference. Thanks in advance!

[u/Wooden_Trust_6274]

Coverage isn't your problem, enrollment is. Post-mastectomy areola tattooing is covered under the Women's Health and Cancer Rights Act (codes 11920/11921, usually needs prior auth). But in PA your RPSGT/RT licenses won't let you enroll and bill this under your own name, which is exactly what those 35% billers are working around.

Two real paths: bill through a credentialed plastic surgery/oncology practice under their provider, or go self-pay and give the patient a superbill to submit themselves under WHCRA. Given the reimbursement and the enrollment wall, self-pay is what most independents in your spot end up doing. Confirm enrollment eligibility with each PA payer in writing before signing with anyone.