The Affordable Care Act
Section 2706 of ACA mandates the inclusion and reimbursement of licensed health care providers in health insurance plans. However, Section 2706 does not specifically list massage therapists as licensed health care providers. Neither does ACA require the inclusion of every licensed health care provider in health plan networks. Networks must include a sufficient number to serve the population, except in the few states having every willing provider clauses. Moreover, insurers have the discretion to determine the provider procedures covered and the prices they will pay for those procedures.
Insurance Companies May Cover Massage Therapy If Prescribed By A Doctor
Its rare for car insurance to cover the costs of massage therapy. However, its not totally unheard of.
Your best option is to get a prescription for massage therapy from a doctor. If a physician prescribes massage therapy to treat your injuries after an accident, then your auto insurance or the auto insurance of the at-fault driver may cover the costs of massage therapy.
Some massage therapists work specifically with car insurance companies. Payments are made directly from the insurance company to the massage therapist.
Massage Therapy & Ontario Health Insurance Plan
Massage therapy treatments are not covered under OHIP, regardless of whether the treatments are provided by a Massage Therapist directly, by a physician or required by a physician. Most progressive extended health benefit plans do cover massage therapy treatments when provided by a Registered Massage Therapist and most do not require a physician’s order to do so. Contact your employer for more information.
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Massage Therapist Insurance Cost
Insurance costs vary from business to business. The price of your insurance package will depend on the size of your business and its location. Itll also be affected by the limits you choose.
But to give you an idea, our professional liability insurance starts at $16.50 a month. Our general liability policies cost from $25.99.
To find out more about massage therapist insurance, head to our website. Or call us at 978.344.4215 and well talk you through your options.
If youre ready to get a quote, you can get one online now. Theres no-obligation and itll only take a minute or two.
Massage Therapy Coverage Via Health Insurance Plans
By Krista DeKuyper | May 31, 2018 | Employee Benefits, Health Insurance, Paramedical Coverage
Massage therapy coverage is a very popular health insurance benefit that is used regularly by many people.
Not surprising, considering how a massage feels great and is very relaxing!
But is massage therapy really a valid health insurance benefit? And how much coverage for registered massage therapists is actually provided by a typical health insurance plan?
Read on and we will explore these questions together.
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General Liability Claims Scenarios
Bodily injury As he gets up from your massage table, a client leans on the headrest. The headrest snaps off and he hurts his arm trying to steady himself. He needs hospital treatment and time off work to recover.
In this scenario, general liability insurance could take care of your clients medical bills and lost wages. If the case went to court, it could pay for your legal defense. And if youre found liable, it could also cover your clients legal fees and their compensation payment.
Personal injury Youre out to lunch with a friend and mention one of your clients . It gets back to your client and she files a suit against you, claiming you portrayed her in an unflattering light.
In this situation, your policy could hire you an attorney, pay legal fees, court costs, and compensation, if necessary.
Property damage During a clients in-home massage you accidentally knock over a computer monitor, breaking it. The PC was expensive and your client expects you to buy her a new one.
Your general liability insurance could pay to fix the damage. Or replace the PC if its beyond repair.
Amta Working On Getting Massage Covered By Medicare
AMTA is working on getting massage covered by Medicare with the Alliance to Advance Comprehensive Integrative Pain Management and it looks like CMS is actually paying attention.
AACIPM says: However, the efforts of AACIPMs many stakeholders were not for naught, as recommendations #2 and #4 from our letter were directly quoted by CMS in their summary of public comments, as they wrote: One commenter recommended that CMS establish a multi-stakeholder working group to determine operational details and resource allocation and requested that CMS establish a pilot program using innovative payment methodologies.https://painmanagementalliance.org/2021/11/30/the-connector-november-2021/
I see a plan starting something like this:
- Contact legislators about a bill.
- Write letters to legislators.
- Do we need a lobbyist to help right it? That costs probably $10k a month or so .
- Create a document with info that shows how massage can help with top medical conditions to give to legislators.
- Figure out how much this would cost and start a fundraiser.
- Contact AMTA and ABMP to see what they are doing.
- Start applying to be a Medicare/Medicaid Provider even though they are not accepting Massage therapists as providers.
- Start sending them bills even though they do not pay so they can be denied just to get into the system.
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Six Insurance Billing Hints
Interacting with insurance companies correctly will pay off. The following hints will help any massage therapist realize that billing insurance isnt very hard:
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Our Direct Billing Process
The office staff at Academy Massage Therapy are happy to assist you with your private insurance policy. As a convenience to our clients, we will submit claims to your insurance company directly whenever possible. We will work our hardest to ensure the accuracy of your claims, but payment by insurance is not guaranteed.
Your insurance policy is ultimately a contract between you and the insurance company. We will do our best to help you, but you are ultimately responsible for the costs of treatment. We typically take payment prior to your appointment, so if it is your first treatment with us, or if the details of your policy may have changed, its important to sort that out with us prior to your treatment. This may mean calling us 48 hours prior to your treatment so we have the correct information on file, prior to your treatment.
All policies differ in coverage amounts and certain policies require a physician prescription prior to your treatment. We are experienced at dealing with most types of policies, but it is important that you are aware of the details of your plan. Feel free to for more information on who we have experience direct billing with, and what information we will require from you.
*Direct billing is not available for osteopathy at this time.
Are There Any Alternatives If Your Insurance Doesnt Cover Massage Therapy
Be open to looking for alternatives in case the massage treatment isnt covered by your insurance plan.
Ask your doctor for options. They may provide you with another form of treatment thats as effective as getting massages but is covered by your insurance policy.
Use your health savings account or flexible spending accounts .
The HSA and FSA are common bank accounts set up by employees through their employers to deposit a certain amount of pre-tax money, which they can use for qualified health care expenses. They may cover the costs of your massage therapy if its deemed medically necessary.
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Will Qualifications Affect My Insurance
Talking about qualifications when trying to buy insurance for your business can be a bit daunting, but it doesnt have to be! Here at Salon Gold, we know that there is often a lot of uncertainty over what qualifications youll need to be covered, so weve compiled all the information youll need to know in this handy guide
Advice For Massage Therapists
For any LMT that wants to accept insurance.
They will need to check with their states governing board to see what requirements must meet in order to bill insurance companies other than Workers Compensation and auto insurance PIP.
Also, it would be a good idea to check with insurance providers in case the client hasnt done the proper checking to see if massage therapy services covered.
LMTs who wish to accept insurance may also want to hire a medical billing.
And coding professional to ensure that the proper codes entered in the proper places and claim forms filled out correctly.
Making sure detailed recordkeeping performed will ensure that the LMT will reimburse for their services.
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Does Medicare Cover Massage Therapy
Key Takeaways:
- Massage therapy is a medically accepted treatment for certain health conditions.
- Medicare coverage of massage therapy depends on who provides the service and why you need it.
- Some Medicare Advantage plans may include benefits for massage therapy.
- State licensing laws regulate how massage therapists can bill insurance companies.
Private health insurers are increasingly covering therapeutic massage as a treatment for certain medical conditions. So, if youre a massage patient transitioning to Medicare, an important and relevant questions to ask is does Medicare cover massage therapy?
The answer depends on several variablesyour Medicare plan, your medical condition, and even your chosen massage therapist. To avoid any unnecessary billing surprises, heres what you need to know about Medicare and massage therapy.
Your Practitioner Must Be Registered
You may notice on your massage therapy receipts that the practitioner lists RMT after their name, meaning Registered Massage Therapist. They must be registered as a massage therapist in the province in which the services are rendered. If an Alberta-registered therapist performs your massage in Ontario, it will not be eligible for reimbursement.
If you wish to look up a practitioner in Ontario, you can find the information online at . For Alberta, you must confer with the Massage Therapist Association of Alberta. Calling the therapist ahead of time to verify can help also, but check with your insurance provider as well, just in case.
There are some situations where a naturopath may administer a massage. If your plan covers naturopathy, your insurance provider will assess the claim under that benefit. However, if your plan excludes naturopathy, it will not be eligible for reimbursement.
Orthotherapy is a treatment that incorporates massage, kinesiotherapy, joint mobilization and other care to restore function to the body. This treatment is typically not eligible if performed in Ontario, but refer to your policy brochure to be certain.
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Who Likely Provides Reimbursable Coverage And Who Does Not
Unfortunately for Medicare and Medicaid recipients.
Massage therapy is generally not covered or reimbursed.
The same often true for persons covered under a Health Management Organization .
It is possible for massage therapy to cover by these as well as major insurance companies.
But it depends on the policy held by the patient or client as well as the state where they live and receive massage treatment.
For example, does Medicaid cover physical therapy in a nursing home?
The answer may very well yes given the patients circumstances.
Different states have different laws and requirements in order for massage therapy to cover or reimbursed after the recipient pays for the massage out of their own pocket.
Insurance types that likely to pay in whole or in part for massage therapy services.
Either directly or through reimbursement are major medical providers such as Humana, Blue Cross, Aetna, etc.
Workers Compensation, and the Personal Injury Protection provided by auto insurance companies in the event of an injury sustained from an auto accident.
Again, this depends on the coverage of the client or patients health insurance plan.
Although some states mandate that they cover massage therapy services should all of the requirements are met.
Look Into Hsas And Fsas
There are a couple of medical-related acronyms that could save you money on massage therapy: Health Savings Accounts and Flexible Savings Accounts .
An HSA is a savings account you can use if you have a high-deductible insurance plan. It lets you put aside pre-tax money for medical expenses.
Some employers offer an HSA that can be used for wellness expenses, Anderson says. And that may include gym memberships and massage therapy.
An FSA, meanwhile, is an account offered as part of an employer-sponsored health insurance plan. It lets you set aside pre-tax money for certain medical expenses. That could include therapeutic massage. To qualify, you might need to get a letter of medical necessity.
According to the Internal Revenue Service, therapy that you receive as part of a medical treatment may qualify for HSA or FSA reimbursement.
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Massage Insurance: What It Is How To Get It
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Massage insurance typically refers to a combination of general and professional liability insurance, which helps pay for legal fees and medical bills that could otherwise bankrupt you and your massage business in the event of a lawsuit.
Beyond liability coverage, those in the bodywork industry may need additional business insurance, such as workers compensation or commercial auto insurance.
Here’s how to assess your risks and find the right coverage for your massage therapy business.
Billing Insurance For Massage Therapy: Things To Consider
As youve probably already gathered from what was said above: billing a health insurance company for massage therapy is no simple task. Its not something you can simply decide to do and then immediately implement into your massage practice. Doing so will require a significant amount of preparation, along with a major amount of follow-through in order to actually execute on the back end.
For that reason, its important to take a moment to consider why you want to participate in insurance company billing in the first place.
Are you simply looking to bring in more revenue from your clients? Some massage therapists want to bill insurance because they believe it would increase their level of income by simultaneously bringing in more patients . In some practice areas, this may be sensible. Particularly if you choose to specialize in something like treatment for post-accident injuries and other acute issues, being able to bill insurance can make a lot of sense.
Theres no question that the thought of being able to treat more patients and increase your revenue sounds like a positive thing. On the flip side, though, there are a number of potential drawbacks that need to be taken into account.
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Massage Therapy: Why Something So Fantastic Has To Be Reasonable And Customary
A massage certainly sounds inviting at the end of a long week, whether your days are filled with back-breaking labour or sedentary sitting in an office. And massage therapy isnt only perfect for relaxation! It is helpful for treating injuries, and also depression, anxiety, digestive disorders, headaches, fibromyalgia and many other ailments.
The after-effects are wondrous, giving you relief from the stresses of life. To some, massage therapy is a real luxury to be paid out of pocket, while others are fortunate to have massage therapy covered under their medical insurance plan.
Massage may very well be the oldest form of medical treatment. For thousands of years, people have sought relief through hands-on therapy. People used to convene in bathhouses and socialize while they were being rubbed down. We have come a long way since then. Gone are the seedy massage parlours, and in their place are luxury spas, clinics, and wellness centers.
There is a huge market for massage treatment, as it is the most sought-after benefit for insurance coverage. Your skin is your biggest organ, and you cannot afford to mistreat it. Your touch receptors release endorphins reducing your stress and making you feel better. Loosening up muscle knots and relieving inner tension are other important benefits.
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Accepting Insurance Plans And Coverage As A Massage Therapist
Not all massage therapists accept insurance.
Some of this is by personal decision and others may not allow doing so.
The biggest reason a therapist may not choose to accept insurance is the headaches that come with the process.
Accepting insurance requires a substantial amount of paperwork.
Claim forms differ depending on the type of coverage that is paying or reimbursing for the therapy.
If the claims not filled out properly.
The medical billing codes arent entered correctly.
And other proper documentation did incompletely or incorrectly.
The therapist will not pay for their services.
Which then results in business losses.
This is especially hurtful to the individual therapist with a private practice.
For this reason, many massage therapists will not accept insurance.
Another reason LMTs may not accept insurance is because they not allowed to do so.
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