Massage therapy services are currently not covered by large insurance companies.  Getting covered depends on why one is seeking care and how the insurance company defines that care.  Your client will be covered and reimbursed if the treatment is deemed medically necessary, or if it meets the insurance company’s criteria.

Further, if a client’s services are deemed necessary for rehabilitation or habilitation, the service may be considered a health benefit and covered.  Insurance companies generally consider massage therapy to be a treatment option for acute conditions rather than for long-term care.


There are many health benefits of massages, including improved circulation, stress reduction, muscle tension relief, neck pain icd 10, and even anxiety relief. In addition to traditional medical treatment, they fall under the category of complementary and alternative medicine (CAM).

Is your insurance company going to cover massage therapy?

Most insurance policies do not cover massage therapy, which is a popular alternative treatment for medical conditions. Massage therapy has a different meaning to insurance companies. If your health insurance policy covers the treatment, it depends on your reasons for wanting or needing it.

Currently, massage therapy is not covered by standard insurance policies but there are some insurance companies like panda who cover massage therapy. Your specific insurer may cover it. Some insurance plans may cover massage therapy in these cases:

  • Your doctor or medical professional may prescribe it or recommend it
  • Whenever it is deemed medically necessary
  • Your insurance company will cover it if it meets their criteria
  • When a treatment is referred to as “habilitative or habilitation”
  • During acute treatment, if it’s necessary

 

CPT codes and masssage therapy

These CPT codes cover procedures carried out in your holistic practice by your massage therapists. If revenue cycle management is disrupted due to incorrect CPT codes, you risk lost revenue.

In accepting insurance coverage, you increase access to your services, but you complicate the payment process as well. If you already have a full schedule in your practice, accurate completion of the paperwork involves time and energy. In order to streamline the insurance billing and reimbursement process, massage therapists should know how to use the most common massage therapy CPT codes.

As a general rule, Massage CPT codes look like this:

97124 – Therapuetic Procedure, 15 minutes. It may include effleruage, petrification, tapotement, compression, and percussion.

97140 – Therapuetic Procedure, 15 minutes. Among other techniques, the therapist uses mobilization, manipulation, manual lymphatic drainage, and manual traction.

97122 – 15-minute therapeutic procedure. This involves retraining the muscles that control movement, balance, coordination, kinesthetic sense, posture, and proprioception.

97010 – Hot and Cold Packs. Based on your training and the codes your insurance company will accept, you will use the appropriate code.  Depending on your training and skill level, you choose the appropriate code.  Codes are typically rated differently by insurance companies, but do not choose a code that may pay more simply because you will get paid more.

97110 – Exercise therapy . This consists of therapeutic exercises performed at regular intervals of 15 minutes to develop strength, endurance, flexibility, and range of motion in a body part. Healthcare professionals must perform this exercise.

Insurance covers what types of massage therapy?

In the health care field, some health professionals use massage techniques. These providers include chiropractors, osteopaths, physical therapists, and occupational therapists. These specialists may be covered by your insurance. Massage therapists are not covered.

Therefore, before booking an appointment for massage therapy, you should contact your insurer first. Understanding whether it’s covered and how much it will cost will help you determine whether or not it’s within your budget.

Massage therapists are healthy

With Healthie, massage therapists can easily schedule, bill, keep notes, and communicate with clients from one program.  For example:

  • Create CMS-1500 insurance claims for batch-downloading and submission to your choice of clearinghouse. Invoice clients for non-covered amounts or control claim statuses and reimbursements within Healthie.
  • With Healthie’s HIPAA-compliant electronic health record, you can safely store your clients’ health information, and you can track their progress through custom-built notes.
  • With our integration with Stripe, you can create custom packages and invoices for your clients. You can also generate payment receipts.
  • You can book appointments online through Healthie’s scheduling feature by creating custom appointment types, setting availability, and booking via our mobile app or web platform.
  • Healthie’s HIPAA-compliant chat feature lets you keep in touch with clients between appointments.

Is there an alternative to massage therapy if your insurance does not cover it?

In case your insurance doesn’t cover the massage treatment, you should look for alternatives. You can discuss your options with your doctor. It may be possible for them to provide you with another type of treatment that is just as effective as getting massages, but that is also covered by your insurance policy.Health savings accounts (HSAs) or flexible spending accounts (FSAs) can be used.

HSAs and FSAs are type of health care savings accounts set up by employers that allow employees to deposit pre-tax money, which can then be used for qualified health care expenses. If it is deemed medically necessary, your insurance may cover the cost of your massage therapy.

 

 

 

 

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