Determining if your insurance covers massage therapy can be hard. This is because coverage varies based on need, types of massage, and therapist qualifications. Knowing the details of your policy is necessary as it lets you make informed decisions about your treatments.
Many insurance companies offer coverage for a variety of medical massage techniques. These can range from:
- Classic stroking and compression
- Percussion manipulation
- Traction
- Lymphatic drainage
For clarity, you should ask your insurance provider about their classification of massage therapy. Ask about its justification and whether there are any caps on annual visits.
Medical Necessity for Massage Therapy
Insurance will cover massage therapy if it’s proven to be needed for medical reasons. Often, insurers require a doctor’s referral or prescription for coverage qualification. The role of doctors is significant in diagnosing the medical need for massage therapy for those with diverse conditions. A referral from your doctor can help you get insurance coverage for massage therapy. It can also be established as an important health benefit.
Massage therapists are not allowed to diagnose medical conditions. Therefore, a prescription or referral from a physician is required for reimbursement.
Types of Massage Covered by Insurance
Some types of massage therapy, like deep tissue or sports massage, may be covered by insurance. This depends on the policy and medical needs. However, some types of massage, like Abhyanga Oil and Aromatherapy, usually aren’t covered by insurance. The same goes for Couples, Hot Stone, and Reiki Massage. Talk to your insurance provider about any restrictions or requirements. They will help you determine if your insurance policy covers the type of massage therapy you’re interested in.
If you are unsure about coverage for a condition, you should discuss it with your healthcare provider. Ask about your insurance’s coverage for that treatment.
Qualifications of Massage Therapists
Insurance may require massage therapists to have specific qualifications. They may also need to be in-network providers. Massage therapists may need certain qualifications to be approved for insurance coverage.
- A valid license
- Completed education and training from an accredited school
- Obtained certifications or board certifications
- Hold liability insurance coverage
If you’re thinking about massage therapy, you must check if the massage therapist is in-network with your insurance. This affects your coverage and costs.
To become an in-network provider, massage therapists must go through a credentialing. Also a contracting process with the insurance company, which typically takes 60-90 days.
Steps to Obtain Insurance Coverage for Massage Therapy
To have coverage for massage therapy, you must:
- Confirm coverage with your insurance company
- Get a doctor’s referral or prescription
- Select an in-network massage therapist.
Verify Coverage with Your Insurance Company
Before booking a massage, confirm that your insurance covers it. When you contact your insurance, ask about codes 97124 (Massage Therapy), 97140 (Manual Therapy), 97112 (Neuromuscular Re-Education), and 97010 (Hot/Cold Pack Therapy). Ask if your policy covers these treatments. If your policy covers massage therapy, ask about any limits or rules. For example, a doctor’s referral or prescription.
Secure a Doctor’s Referral or Prescription
Securing insurance coverage for massage therapy involves the following steps:
- Speak with your doctor about the need for massage therapy.
- Confirm with your medical insurance if they provide insurance covering massage therapy.
- If your doctor thinks massage therapy is needed for your condition, they can give you a prescription or referral. This will raise the chance of insurance covering it.
Common conditions need a doctor’s referral for massage therapy. They include chronic pain, muscle injuries, insomnia, TMJ, anxiety, and nerve pain. These conditions often benefit from a targeted massage treatment.
Choose an In-Network Massage Therapist
Choosing an in-network massage therapist is important to guarantee coverage. Therapists in the network completed a credentialing process. The insurance company approved them to serve policyholders. To find a list of in-network massage therapists from your insurance company, use the provider directory from your insurer. Or, contact the insurance company directly and ask for a list of in-network massage therapists.
Choosing an in-network massage therapist offers benefits. These include lower costs and a faster reimbursement process. It also secures quality care.
Alternative Payment Options for Massage Therapy
If your insurance doesn’t cover massage therapy or you’re exploring other payment methods, you might want to consider:
- Health Savings Accounts (HSAs)
- Flexible Spending Accounts (FSAs)
- Discounts at massage schools
- Buying massage therapy packages or memberships
Each option saves costs. It makes massage therapy, an alternative treatment, more accessible. See our blog on how much a massage session costs. See our blog on how much a massage session costs.
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)
HSAs and FSAs are tax-advantaged savings accounts. They let people save pre-tax money for medical expenses, including massage therapy. To use HSAs and FSAs to cover massage therapy, you may need a Letter of Medical Necessity from a doctor. Once you have all the documentation, you can link your HSA or FSA debit card to your massage therapy account to make payments.
Discounted Services at Massage Schools
Massage schools often have discounted services; students gain experience under supervision. Rates for discounted massages at massage schools may vary. Some examples include $35 for a 50-minute session, $30 for a 50-minute Swedish massage, and $45 for an 80-minute Swedish massage.
The quality of massage at massage schools may differ from that of professional massage therapists. However, students are supervised by experienced instructors or working professionals during their training. Making it a safe and effective learning environment.
Massage Therapy Packages and Memberships
Massage therapy packages and memberships offer cost savings. They are great for people without insurance. Packages usually include many massage sessions at a discounted rate. Memberships involve a regular fee for a monthly massage and reduced rates for more. Package prices and memberships vary depending on the provider, location, and massage duration.
For the most accurate pricing, contacting the specific massage therapy provider is recommended.
Insurance Coverage for Specific Conditions and Treatments
Insurance policies are different in coverage for certain conditions and treatments. For example, chronic pain management, recovery after surgery, mental health, and stress relief. Understanding these coverages, like health benefits, can guide you in making smart decisions about your massage therapy options. This is especially true when deciding if insurance covers therapy, such as massage.
Massage Therapy for Chronic Pain Management
Insurance may cover massage for chronic pain if a doctor deems it necessary. Many studies have shown that massage therapy is effective for chronic pain. For example:
- Reducing pain
- Improving mobility for subacute and chronic back pain
- Osteoarthritis
- Hand pain
Techniques like Swedish massage, deep tissue, trigger point, and myofascial release are used to manage chronic pain. Sports massage is used, too.
Massage Therapy for Postoperative Recovery
Insurance may cover postoperative recovery massage, depending on the policy and medical need. Studies have shown that massage therapy is helpful and safe. It is used as an add-on treatment for postoperative recovery. Therapy has several benefits, including:
- Reducing inflammation and scar tissue
- Increasing blood flow
- Healing swelling and bruising
- Enhancing nutrient delivery
These benefits aid in the healing process and promote a faster recovery. These techniques include deep tissue massage and IASTM. They are used for postoperative recovery. Remedial and therapeutic massage are also common for this.
Massage Therapy for Mental Health and Stress Relief
Massage therapy for mental health and stress relief may not be covered by insurance. But you can explore other payment options. Studies have shown the positive effects of massage therapy. It helps to reduce stress, anxiety, and depression. It is an effective part of treatment and supports mental health.
Insurance may not cover massage for mental health and stress relief. Consider using HSAs or FSAs. You can also get discounted services at massage schools or use massage therapy packages and memberships.
Navigating Insurance Coverage Challenges
To address coverage challenges, you must appeal denials. You must also keep up with policy changes. Knowing how to tackle these challenges helps secure the care you require.
Appealing Insurance Denials
If your insurance denies coverage for massage therapy, consider appealing. Use documents from your doctor to support your appeal. Doctors provide medical documentation. They support appeals of insurance denials of massage therapy. Doctors can help by providing letters or studies. These should show the medical need and benefits of massage for your condition. They will support the appeal and back up the request for coverage.
Staying Informed About Policy Changes
Staying up-to-date with changes in your insurance policy is necessary. They could impact massage therapy coverage. Insurance companies usually revise their policies every 6-12 months or once per coverage period. They may also change them any time there is an increase in premiums, a decrease in benefits, or a major event.
To stay informed of health insurance changes, use resources like Healthcare.gov, CMS.gov, and insurance company websites.
Massage Magazine Insurance Plus Coverage for Massage Therapists
At Massage Magazine Insurance Plus, we understand the value that massage therapists bring to their clients’ lives. That’s why Massage Magazine Insurance Plus offers comprehensive coverage tailored specifically for massage therapists. We believe in supporting the professionals who help others maintain their health and well-being through various massage techniques.
Massage Magazine Insurance Plus provides robust coverage options that include:
- Professional Liability Insurance: Protects against claims of malpractice or negligence.
- General Liability Insurance: Covers accidents and injuries that may occur during a session.
- Product Liability Insurance: Safeguards against claims related to products used during treatments.
- Business Personal Property Insurance: Protects your equipment and workspace.
We recognize the critical role massage therapy plays in promoting overall health, from relieving chronic pain to reducing stress. As a massage therapist, you deserve to have peace of mind knowing that you’re protected while you care for your clients.
Regarding your personal health insurance, we hope your provider recognizes the same benefits of different types of massage therapy as we do. Whether it’s deep tissue, sports massage, or lymphatic drainage, the therapeutic effects of these treatments are well-documented. We encourage you to discuss with your health insurance provider to ensure you receive coverage for these beneficial therapies.
Summary
Understanding insurance for massage and managing coverage challenges is necessary. It makes sure you get the care you need. Follow the steps in this guide. Stay informed about policy changes. Consider other payment options. By doing these things, you can use your insurance and enjoy the many benefits of massage therapy.
FAQS
Can HSA cover massages?
You can use your HSA to pay for massage therapy. But you need a letter from your doctor saying it’s medically necessary. Make sure you get a note from your primary care physician to take advantage of this health benefit.
Does Massage Envy take insurance?
No, Massage Envy does not accept insurance; however, they do accept HSA/FSA debit cards. They also offer an introductory rate of $60 for a 60-minute session or $90 for a 90-minute session for first-time customers.
How often should I get a massage?
It is recommended to start with more frequent treatments for the first few weeks and then aim for a massage once a month or every other month. Competitive athletes may schedule one to two massages a week. If you have a chronic condition or specific areas of strain and tension, consider scheduling a message every one to three weeks.
Does insurance cover all types of massage therapy?
You must check your insurance before getting a massage. Coverage depends on your policy and medical needs. Your healthcare provider will also help you determine if your desired massage therapy is covered.
What qualifications are required for massage therapists to be eligible for insurance coverage?
To get insurance coverage, massage therapists must have a valid license. They must also graduate from an accredited school. They must also get certifications and carry liability insurance.
About the Author:
Hannah Young
Hannah Young is the Associate Director of Marketing for Massage Magazine Insurance Plus (MMIP). Hannah has dedicated her career to the advancement of the massage therapy industry by spearheading the MASSAGE Magazine and MMIP family of brands. Her impactful efforts extend beyond the corporate realm, as Hannah has successfully raised substantial funds for massage therapist grants and foundations. Notably, she spearheaded the establishment of the annual Massage Therapist Appreciation Week, a testament to her dedication to recognizing and honoring the contributions of massage therapists.
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