Today, about one in three adults uses alternative therapies to manage their health conditions. Massage therapy is an effective treatment for reducing stress and fatigue and relieving pain from injuries and chronic disease. Massage therapy also helps lower your heart rate and blood pressure, increase circulation, improve range of motion, and release endorphins, all of which complement traditional medical therapies. Even though massage therapy has been proven to treat many conditions many people are unaware if therapeutic massage is covered by their insurance.
The Affordable Care Act changed the way insurers pay for alternative treatments such as massage therapy. Under the law, health insurance companies can’t discriminate against licensed health professionals who practice alternative medicine, including massage therapy.
Unfortunately, the non-discrimination clause doesn’t require insurers to cover massage therapy, but the good news is that more insurance companies do cover it than in the past, thanks to the ACA. Here’s what you need to know about insurance coverage for massage therapy.
Which insurance companies cover massage therapy?
Every insurance plan is different, so it’s best to check with your plan administrator before you make an appointment. Medicare does not cover massage therapy under any circumstances, and HMOs generally have more restrictive payment policies for alternative medicine.
If you’re under Worker’s Compensation or an auto accident claim, your massage therapy treatment is generally covered. You may need to pay at the time of service and get reimbursed, however, so be sure to keep careful records of your treatments and payments.
Do I need a prescription for massage therapy before insurance will pay?
Most insurance companies that cover massage therapy require a written prescription from your doctor before they pay. If you want massage therapy for your condition, let your doctor know upfront and ask for a prescription. Many doctors may not offer or suggest massage therapy on their own, but are willing to approve it if the patient requests it.
Licensed massage therapists can’t diagnose patients or write prescriptions, so they must follow your doctor’s orders. A more general diagnosis of muscle pain gives the therapist maximum flexibility to treat you, whereas a specific prescription of massage for right arm pain limits your treatment options.
Can I use my HSA or FSA for massage therapy?
If you have a prescription from your doctor, most people have no trouble using their FSA or HSA dollars to pay for massage therapy. However, you should contact your HR department or insurance company to verify, just in case.
What paperwork will my insurance company need to pay for massage therapy?
Paperwork requirements are different for each insurer, but your prescription should include a diagnostic code such as M54.6 for back pain or whatever condition the therapist is treating. Some insurers also require the doctor to specify the number of treatments on the prescription. These factors can impose coverage limitations so be sure to discuss it carefully with your doctor.
Insurance companies may require pre-approval before they pay for massage therapy services. If you call for pre-authorization, be sure to ask how many sessions or “billable units” are covered and how many minutes are in a billable unit. Your massage therapist will code the sessions based on the type and length of the service provided.
It’s also a good idea to ask if there are provider restrictions on coverage for massage therapy. Some insurers only pay for services from providers within the plan’s network.
Even if your insurance company doesn’t cover massage therapy in the same way it pays for other medical services, it may offer discounted services with certain providers. It never hurts to ask.
Whenever you’re trying to get insurance coverage for massage therapy, it’s almost always a good idea to call the insurer directly before you book a massage. That way, you’ll avoid unpleasant surprises when it’s time to pay the bill.