Insurance FAQs for Medical Massage Therapy


 

Click to read the following questions and answers:


 

Will insurance pay for medical massage therapy?

You may be eligible for partial insurance reimbursement if you meet the following three requirements:

  1. You have called the benefits department of your insurance company and you have determined that your policy covers medically necessary massage.
  2. You have determined that your insurance carrier and policy allow for reimbursement to out-of-network health providers.
  3. You have acquired a prescription for medically necessary massage from a licensed physician. We highly recommend that you print out the prescription form provided on this page and take it to your doctor. Using our form will help your doctor to provide all the information we need.

 

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What types of massage will be covered by insurance reimbursement?

Your doctor must diagnose a disease that presents symptoms of dysfunction related to the soft tissues. When insurance reimbursement is involved, the massage therapist can treat only the areas of the body specified by the doctor on the prescription and can treat only for the specified amount of time.

 

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How do I acquire a prescription from my physician?

If you believe you have soft-tissue pain related to a medical condition, follow these steps:

  1. Print out the prescription form and give it to your physician. The form instructs your doctor on how to complete a prescription for medically necessary massage.
  2. Refer your doctor to this website or ask your doctor to contact Joan Sloss at (303) 986-0492.

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How does medical massage differ from relaxing massage?

Medical massage is result-oriented and the treatment is specifically directed to resolve conditions that have been diagnosed and prescribed by a physician. The therapist may use a variety of modalities or procedures during the treatment, but will focus the medical massage treatment only on the areas of the body related to the diagnosis and prescription.

Medical massage is generally billed in 15-minute segments using current procedural terminology and adhering to the usual and customary reimbursement fee schedule. As with physical therapy sessions, medical massage sessions are prescribed by a physician for specific issues, are limited to a physician-designated course of treatment, and can be compensated through insurance.

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Will worker’s compensation pay for medical massage?

Yes, medical massage treatments are covered when authorized by your worker’s compensation caseworker and when a doctor provides a prescription for medically necessary massage. If you receive a work-related injury, you should file a worker’s compensation claim with your employer, consult with your physician concerning your condition, and obtain a prescription for medical massage. Call us for your initial appointment. Please have your insurance information in front of you when you call.

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What are the payment rates for medical massage?

Insurance billing rates for submission of claims differ from the regular clinic prices. These rates reflect charges that have been deemed usual, customary, and reasonable by the American Medical Association.

 

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What health conditions are typically treated by medical massage?

Your health insurance may cover medical massage therapy when a doctor believes this service will help with the healing of injuries or soft-tissue diseases. Such diseases include the following: sprain and strains, carpal tunnel, tennis elbow, rotator cuff problems, sciatica, hypertension, fibromyalgia, circulation problems associated with diabetes, lymphedema, pregnancy and post-natal recovery, and post-surgical recovery, among others.

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Can I receive massage treatments when I have been injured in a car accident?

Consult with a licensed physician. You will want to seek immediate and appropriate medical care for your injuries. You may need to acquire the services of a lawyer. You will need to pay out-of-pocket for medically prescribed massage treatments and then submit the paid invoices to your lawyer.

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Will I spend more time at the massage clinic when I have a prescription for medically necessary massage?

Yes, you will spend more time at the clinic on your first appointment. At the first appointment we will review your paperwork and ensure all items are complete. You will receive an initial consultation and evaluation before your first treatment. Your treatments will be based on a plan for improvement. Please allow 90 minutes for the initial visit.

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Ready to begin your journey to wellness?
Call us at (303) 986-0492 to set your appointment.