Is Massage Therapy Covered By Insurance?
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Massage therapy can be covered by your health insurance plan if it is considered medically necessary and/or fits the criteria of coverage given by your healthcare provider. This means only certain types of massage will qualify, such as stroking, compression, percussion, manipulation, traction and lymphatic drainage. Other forms of treatment such as hot stone, aromatherapy, couples massage, abhyanga oil massage and reiki are likely not covered under your health plan. Because massage therapy is still considered to be an alternative form of treatment, it is not a guarantee that it will be covered by your provider. If this is the case, you should contact your primary care physician and request a referral and/or prescription for massage treatment. Most who do get a referral go on to receive coverage for massage although it is not guaranteed.
Keep reading and see what your options are for massage therapy and how to get coverage.
Do All Types of Massage Therapy Qualify for Coverage?
Not all massage therapy is covered by health insurance. Healthcare practitioners and providers have to use billing codes to help insurance providers quickly and effectively authorize coverage. In the case of massage therapy, healthcare professionals use two codes:
- 97124: Stroking, compression, percussion
- 97140: Manipulation, traction, lymphatic drainage
Below is a table explaining what each of these forms of massage therapy is:
There are several forms of massage therapy that are not typically covered by insurance. Below is a table explaining what these treatments are:
Abhyanga Oil Massage
Hot Stone Massage
Whether massage therapy is covered by your insurance company will depend on how treatment is defined and the reason for seeking treatment. Below is a breakdown of when a massage treatment may be covered by your insurance company:
- A massage is considered medically necessary and/or fits the criteria of coverage given by your healthcare provider.
- Massages that aid in the rehabilitation process after an accident or surgery may be covered by your insurance.
Why Doesn’t Insurance Always Cover Massage Therapy?
Massage therapy is considered an alternative form of treatment similar to chiropractic, which insurance companies don’t always cover. Also, massage therapy may not be covered by your provider if it is considered maintenance because treatment that is supportive rather than corrective is not covered by health insurance. You likely won’t be covered if a significant change is not expected to come from further treatment.
Ways To Get Massage Therapy Covered
There are multiple ways you can look into getting massage therapy either completely or partially covered.
Ask Your Insurance Provider if Your Plan Covers Massage Therapy
Call your health insurance company’s customer support or view your benefits online or on your provider’s mobile app. If you do speak to someone, ask the following questions:
- How do I know if massage is covered by my plan?
- Do I need to have a specific diagnosis in order to get coverage for massage therapy, such as back pain?
- Will a note from my primary care physician (PCP) saying massage therapy is medically necessary cover me?
- Do I need to see a specialist such as an orthopedist or osteopathic doctor in order to get a referral so I can get coverage for massage therapy?
- Am I limited to a certain number of visits or by a length of time for each visit?
- How do I schedule a massage that is in my network?
- Is the in-network massage therapist only at a specific location or facility?
*Your insurance company may say each visit is limited to a particular amount of billing units. Ask your provider how long these billing units are.
Get a Referral From Your Primary Care Physician
If your insurance will not pay for massage treatment you can ask your PCP if they will make a referral for you to seek massage therapy. Up to 67% of people who ask their PCP for a referral get one granted. Since massage therapists are not licensed to diagnose medical conditions, getting a referral from a doctor is important when seeking reimbursement.
Explain Why You Want Massage Therapy
To get a note from your doctor, you will need to be able to explain why you think you need massage therapy. Let him or her know what it is that is ailing you and suggest massage therapy as a potential treatment. Because of massage therapy's success in managing pain, your doctor may prescribe sessions for you as an alternative to painkillers, which are highly addictive. The
American Massage Therapy Association lists 25 reasons why someone may want or need massage therapy:
- Relieve stress
- Relieve postoperative pain
- Reduce anxiety
- Manage low-back pain
- Help fibromyalgia pain
- Reduce muscle tension
- Enhance exercise performance
- Relieve tension headaches
- Sleep better
- Ease symptoms of depression
- Improve cardiovascular health
- Reduce pain of osteoarthritis
- Decrease stress in cancer patients
- Improve balance in older adults
- Decrease rheumatoid arthritis pain
- Temper effects of dementia
- Promote relaxation
- Lower blood pressure
- Decrease symptoms of Carpal Tunnel Syndrome
- Help chronic neck pain
- Lower joint replacement pain
- Increase range of motion
- Decrease migraine frequency
- Improve quality of life in hospice care
- Reduce chemotherapy-related nausea
Risks of Massage
There are some potential risks to massage therapy according to the Mayo Clinic that you should consider before getting treatment. They include:
- A bleeding disorder or you take a blood-thinning medication
- You have burn wounds on your body
- Deep vein thrombosis (DVT)
- Any infections
- Any broken bones or fractures
- Severe osteoporosis
- Severe thrombocytopenia (very low platelet count)
The best way to get coverage for massage therapy is to have the right health plan. Enter your zip code below or call 855.214.2291 to receive your free health insurance quotes in minutes.