Does Health Insurance Pay For Massage Therapy
Posted on: February 17, 2020
Since different companies provide health insurance coverage in the United States, it’s impossible for an article about this topic to give readers a definite answer about their unique individual situations. Private insurance carriers, Medicare and Medicaid requirements and other factors come into play when discussing massage therapy. People usually can’t receive coverage for any form of massage therapy without a doctor’s referral that clearly states that the therapy is medically necessary. Most health insurers pay for medically necessary treatments performed by a licensed massage therapist. Insurers typically don’t cover trips to the day spa for people who believe that a nice massage would feel great on a particular day.
It’s always best that you check with your insurance provider about your coverage. A member service representative at the number on your insurance card can go over the types of massage that your policy covers. If you’re too ill to make that call, your doctor or one of their staff members can check with your insurer before you start treatment. Additionally, it’s important to keep in mind you have other options if your insurer won’t pay and you absolutely need therapy: Most licensed massage therapists, like other medical professionals, offer patients multiple payment options, such as a large discount for paying in cash upfront and low- or no-interest installment repayment plans.
How To Get Approved To Accept Insurance For Massage Therapy
Some states require massage therapists to carry liability insurance as part of the licensing requirements to practice as a massage therapist. Even if insurance is not required in your state, protecting yourself from lawsuits by paying a few dollars a month for a liability insurance policy is generally a good idea. Most major massage therapist professional organizations offer a group rate on liability insurance for members or an insurance rider is automatically included as part of the benefits package when you pay dues to join the organization.
1
Complete your massage therapy training. Most massage therapy programs require at least 500 hours of study and take six to 12 months to complete. Subjects studied include anatomy, physiology, kinesiology, business management and ethics, as well aslots of practice in various massage techniques.
2
Apply to become a licensed or registered massage therapist in your area. Almost all states and some cities regulate the practice of massage therapy. Licensing typically requires graduation from an accredited school and passing a written and/or practical exam.
3
References
Whats Best For Clients
There are great companies that contract with insurance companies and massage therapists like American Specialty Health . These companies create a viable space for massage therapists to participate in their networks. They assume the responsibility of dealing with the insurance companies. Massage therapists are able to do what they do best provide a great service and get paid adequately for their services immediately by the customer or through ASH directly within days of the service. The process of getting in their network is stringent but worth it to massage therapists who want to dive into medical massage. Its a route that I took for a while but didnt match the type of service I wanted to provide and eventually removed myself from the network.
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Medical Benefits Of Massage Therapy
Massage therapy feels great and also has the following health benefits:
- It has been found to be an effective treatment for back pain .1
- It improves circulation of the massaged area as well as overall circulation in the body.
- Massage therapy can be used to treat and prevent tension headaches.
- It can be used to boost the immune system by increasing the white blood cell count in patients.2
- It can help improve sleeping habits, especially patients who are undergoing chemotherapy or radiation treatment for cancer.
- Massage therapy can improve joint mobility.
- It can also reduce tension in the body, which has many negative health effects.
Massage therapy is widely used to treat both chronic ands acute medical conditions that can result from either an injury or illness.
What Related Services Might Medicare Cover
If youre wondering what Medicare will cover, there are a few types of treatments you can look at, including:
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Physical Therapy: Medicare will cover some physical therapy treatments as long as it is prescribed by a registered medical practitioner.
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Chiropractic treatments: Medicare will pay for some forms of chiropractic that are intended to treat lower back pain.
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Acupuncture treatments: Medicare will cover acupuncture in very specific circumstances and if it is performed by a licensed acupuncturist in your state.
If you suffer from lower back pain and all other treatment options dont work, youll be able to get up to 20 acupuncture sessions in a calendar year.
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Prescription Drugs: If you have Medicare Advantage or a Part D Plan, you may be able to get your prescription drugs for pain and inflammation covered.
If you have Original Medicare, youll be covered for 80% of your doctors costs but will have to pay for your medication on your own.
Medicare will only cover treatments that are considered medically necessary and which are approved by the Centers for Medicare and Medicaid Services .
Source: Pexels
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Can I Use Insurance To Pay For A Massage Chair
We get asked that question a lot, and the answer is yes and no. If you have already used your deductible and you would like your insurance company to cover the cost of a massage chair, the answer is almost always no. When Worlds Best Massage chairs wrote this, massage chairs do not have an insurance medical code or DME and cannot be covered by insurance. BUT, the question is can you use your FSA or HSA to cover some or all of the costs.
For some of you, the answer is YES! Why only some? Because to get compensation from your insurance company to pay for your massage chair, youll, in all likelihood, need to meet two conditions:
- You have a chronic back issue, and perhaps a history of claims to treat your condition
- You have either an HSA or an FSA .
Think you might qualify? If you have had chronic back pain, well leave that to other blog posts to explore this condition certainly, it is one of the reasons people buy a massage chair. But for this article, lets take a look at the HSA and the FSA to understand better how they work and why they may qualify you for a massage chair purchase.
Billing Insurance For Massage Therapy
Regardless of your situation and insurance provider, you must have a recommendation from a doctor to treat a specific medical condition which includes the recommended number and length of massages. With that said, here are some instances in which you may be able to have insurance pay for some or all of your therapeutic massage treatments:
- Health Savings Accounts : Some health insurance companies offer high deductible plans that may be paired with a health savings account. A health savings account is a bank account that you use to pay for qualified medical expenses with tax-deductible contributions . So while you are still paying out-of-pocket, there are substantial savings available through the tax advantages.
- Personal Insurance Protection : This type of insurance is an extension of auto insurance plans and covers medical bills for injuries resulting from auto accidents.
- Workers Compensation Insurance: Therapeutic massage for work related injuries can often be covered by workers compensation insurance. If youve been involved in an accident at work, check with your insurance provider to see if massage therapy is covered.
While these options are available to help cover the costs of therapeutic massage in North Carolina, only a small percent of the population can take advantage of them. If you feel that therapeutic massage for pain relief should be covered by health insurance in NC, I encourage you to with the North Carolina Department of Insurance.
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Massage Therapy Continuing Education
If youve decided to attempt to bill for health insurance as part of your massage practice, this guide should have provided you with a solid overview of what youll need to know and where to start. Again, we highly recommend contacting your state massage licensing board for more information.
Remember, though: growing your practice isnt limited to taking insurance in order to bring in new clients. Massage therapy continuing education courses from Panda can give you the skills you need to offer new and exciting services to a wider range of clients. As an NCBTMB approved provider of massage CEU courses, Panda offers the best value available anywhere when it comes to online massage CEUs.
Therapy Not Covered By Insurance
If your health insurance does not cover massages, but you have a health savings account , you may be able to use it to cover massage costs, if your massage qualifies as medically necessary. Learn more about HSAs and flexible spending accounts here. Contact local massage schools to see whether they offer massages at a discount. Ask for discounts or membership options where you get your massage services.
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How Much Does Massage Therapy Coverage Cost
Like all benefits, the more coverage a policy offers, the more its likely to cost. The cost will vary by insurer.
Signing up for health insurance through an employer can save you money. Thats because the employer will often pay part of the cost of the premium for you. It may also offer health insurance plans with more benefits, like massage therapy.
If the massage is considered rehabilitative or is medically necessary, then insurance will not cost you more. It may fall under the coverage of the Affordable Care Acts 10 essential health benefits.
Employee Benefits Coverage For Massage Therapy
There are two main types of private health insurance in Canada: employee benefits and individual health insurance plans.
Employee benefits are also called group insurance, and coverage is obtained through your employer. If you lose your job then you also lose your benefits coverage.
Massage therapy is just one of the coverages that come under what is called paramedical benefits. As mentioned previously, paramedical coverage consists of things such as chiropractic, physiotherapy, massage therapy, naturopaths and speech therapy.
The following summarizes employee benefits coverage for massage therapists:
- Included as a paramedical coverage.
- There is usually no per visit maximum .
- Coverage is limited by annual plan maximums that are applied to each type of paramedical coverage .
- Most group plans require a referral from a doctor.
- Annual coverage maximums range anywhere from $350 to $750 per year.
- Generally speaking, employee benefit maximums are higher than maximums with individual health plans.
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Insurance Covered Massage Therapy
Did you know that your insurance may cover your massage therapy? Of course, this depends on the insurance plan and carrier with whom you have your insurance. While some insurance plans cover massage therapy, there are typically restrictions. For example, some plans cover massages under the guise of chiropractic care. Other plans might cover only a portion of care, such as the initial 15 minutes of a massage. You should be able to determine if your insurance covers massage therapy by taking a closer look at your health insurance policy. Otherwise, your insurance agent will be able to tell you point-blank if your coverage includes massage therapy.
Provincial Healthcare Coverage For Massage Therapy
Provincial healthcare plans such as OHIP, AHCIP and MSI form the basis of the universal Canadian healthcare system .
These publicly funded healthcare plans provide coverage for medically necessary services only, however. As a result, most registered massage therapy is not covered by public healthcare.
The exception to this may be massage therapy that is received in a hospital and is deemed necessary to the recovery of a patient.
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Extended Healthcare & Massage Coverage
Many extended healthcare plans offered by Canadian employers include provision for massage therapy. As part of your regular routine, massage is an excellent way to maintain good health and help prevent injury from the repetitive strains of your daily life.
If you’re not sure whether your benefits package included massage therapy, you can either check the benefits packet from your employer or simply call your insurance provider. In order for massage to be covered by any insurance plan, the services received must be completed by a Registered Massage Therapist . You may also be required to submit a doctor’s note recommending that you receive massage therapy.
Some insurance plans cover massage therapy but only up to a certain amount per visit. This may be a dollar amount or a percentage. Any amount not covered by your insurance company must be paid on completion of the treatment.
DIRECT BILLING
Some insurance companies allow Assignment of Benefitsthe provision that allows a massage therapist to bill them on your behalf so that you are not required to pay for treatment up front.
Currently, both GreenShield and Blue Cross allow massage therapists direct, online billing services. The only paperwork you will need to provide is a doctor’s note, if required under your plan.
If you have insurance coverage under any other health care plan, and would like us to complete billing for you, please call them to verify that they allow assignment of benefits.
Most Frequently Asked Questions About Massage Therapy Cpt Codes
CPT stands for Current Procedural Terminology . The American Medical Association manages the oversight of the codes that give definition and structure to the procedures and services performed by physicians and health care providers across the country.
We know that massage therapy CPT codes can be challenging here are some of the most frequently asked questions:
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Questions To Ask About Massage Therapy Coverage
If you learn that your insurer covers massage therapy, ask these questions so you will understand how your policy will cover it:
- What are the conditions to qualify for reimbursement?
- Is there is a deductible or any out-of-pocket cost to you?
- Is there is a maximum amount payable per policy term/year?
- Is there a maximum reimbursement per visit? For example, if the maximum per visit is $90, and you use a massage therapist who will charge $150, you will not be able to claim the full amount.
- Is there a time limit per body region?
- Are there specific massage therapists you must go to?
- Do all types of massage qualify for coverage?
How To Get Massage Therapy For Cheap
An insurance policy that covers more services costs more than those that dont. The premium of the insurance plan also varies from one insurer to another.
How much you need to pay for your massage therapy will depend on whether or not its covered by your insurance. Call your insurance company to know if you will get reimbursed and how much is your deductible.
You may find affordable services through the following:
- Look for local massage schools that offer massage therapy services at affordable or discounted prices.
- Ask massage service providers if they have special deals, or if they offer discounted rates.
- Find a licensed massage therapist that offers discounts for clients who pay cash upfront or those that offer low-cost installment repayment plans.
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Get Licensed And Credentialed
Insurance acceptance is not a slam-dunk under ACA. Stay current on licensing requirements for your state, massage therapist credentialing requirements for the authorized ACA provider networks in your area and the Current Procedural Terminology codes for massage therapy. Moreover, massage therapy is complementary and alternative medicine according to the National Center for Complementary and Alternative Medicine. Follow the general CAM insurance reimbursement guidelines, which state that such therapies can be reimbursable under Department of Health and Human Services CFR 410.43 provisions when prescribed by a licensed medical practitioner, are reasonable and necessary, are goal-directed based on a documented treatment plan, and when the patient shows improvement.
References
What Are The Questions You Need To Ask Your Insurer About The Coverage For Massage Therapy
After youve confirmed that your insurer covers massage therapies, there are a few other questions you need to ask. This will help you understand how your insurance policy works in terms of getting this type of treatment.
- What are the requirements you need to meet to qualify for reimbursement?
- Is there any out-of-pocket cost? How much do you need to pay?
- What is the maximum amount that your plan will cover for every visit?
- What is the annual maximum amount payable for every policy term?
- What is the maximum time limit for the massage therapy session? What is the session time limit for each body region?
- Is there a list of massage therapists whose services are covered by your insurance plan?
- What types of massages are covered?
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Why Are Independent Agents So Awesome
Your assets and your business are not something to mess around with. Massage therapy can be provided from a variety of places office, rented space, home, hotels, spa, etc.
Depending on where you practice will determine the insurance you need. Our independent agents can help you get the best insurance needed for your business, and we wont even ask for a free massage in return.
What To Do If Services Are Not Covered
If you are unable to guarantee coverage or reimbursement from your clientâs insurance company for services, you can employ a variety of other payment techniques that may be enticing to clients.
⨠Accept an HSA/FSA Card
Flex Spending Accounts and Health Savings Accounts are commonly used bank accounts that employees can set up through an employer to set aside pre-tax money to pay for qualified medical expenses.
By accepting FSA and HSA cards for massage therapy services, youâll enable your clients to use pre-tax dollars, that they have already set aside for healthcare expenses, to work with you. You will still get paid for your services, but you and your clients can avoid the stress of dealing with insurance companies or having to pay fully out-of-pocket.
⨠Include services in a package at a discounted rate
While this option still requires a client to pay out-of-pocket for your services, including massage therapy within a package at a discounted rate can help clients who need your services, but are struggling to pay. For example, if you charge $100 per session, you can offer a package of 5 sessions for $425, to make services more accessible to your clients lacking coverage.
This is also a great strategy for keeping your calendar full and ensuring consistent client appointments. With a package, clients are more likely to follow-up sessions, and use all of their credits. They wonât disappear after one or two appointments.
⨠Offer a Superbill
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