In Insurance Massage Therapy Not Always Covered

In some policies of health insurance massage therapy may not be a covered benefit.

Some policies consider any type of bodywork to be for relaxation and not medically necessary and, therefore, not a covered benefit.

Some policies will allow coverage under certain conditions such as medical massage for an injury or pain. There must be a valid medical diagnosis (ICD-9) code and a valid CPT (current procedural terminology) code on the bill.

Many plans will also require a referral from a physician. HMO's require a referral from the patient's PCP (primary care physician). Some require that the therapist be a part of their network of covered providers.

Still other plans will not cover a massage therapist unless the therapist works in the same office as and under the supervision of a covered physician. Other plans do not recognize massage therapists as a covered provider of service no matter where they practice.

Some plans will want a copy of a prescription from a medical doctor stating the diagnosis, the specific types of treatment to be done, the frequency of treatments, and the length of time for the treatments or there is no coverage.

Explore each type of insurance policy--both your clients' and your own to see if coverage is available.

I know a great deal about health insurance coverage as I have been in the health insurance business, processing medical claims since 1981. I have worked for six different insurance companies over the years and they all work in much the same way.

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