Health Insurance and Massage Therapy

I have been a massage therapist for quite some time now. I’ve looked into different ways to market my services, which includes telling customers that I accept and bill health insurance. I tried this on and off for about three years before I finally called it quits. 

Working with insurance companies can be a hassle regardless if you’re the client or massage therapist. In this post, I’ll sum up why it’s harder for massage therapists to accept and bill health insurance companies and what clients can do to seek reimbursement for medical massage therapist services.

The Health Insurance Headache

The main reason I looked into accepting health insurance was because my clients or potential clients would ask about it. The number of them who asked sparked my interest to seek to become a medical massage therapist. Here’s what I found: 

  1. Massage therapists are able to bill for massage therapy or manual therapy under specific billing codes.
  2. There are a number of different networks that work with health insurance companies and offer massage therapy as part of their coverage. 
  3. If your doctor prescribes massage, a massage therapist can use that prescription to get reimbursed for massage. 
Sounds great, right? It looks like it could be a win-win for all. 

Filling out insurance claimsThe truth of the matter is, health insurance companies make it very difficult to file claims and get paid for your services. If going the insurance route, an hour service would take about three times as much time in paperwork and processing to get paid 50 percent of your costs weeks to even months later. Heck, I once received payment over six months later for $15. 

After experiencing this I dropped out of the insurance game. This is why physical therapists, doctor’s offices, and chiropractic offices have a billing department. This is also why these facilities see large numbers of people at one time. As insurance companies become aggressively more rigid in their billing, the quality of care in medical facilities will diminish as will customer service. This didn’t fit into my business model or who I am. I prefer quality over quantity. 

In the end, don’t hate the player (medical facilities), hate the game (insurance companies).

What’s Best for Clients

There are great companies that contract with insurance companies and massage therapists like American Specialty Health (ASH). 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. It’s a route that I took for a while but didn’t match the type of service I wanted to provide and eventually removed myself from the network. 

How To Bill Health Insurances Yourself

There are ways to have your massage services paid for by your health insurance companies.

  1. Enroll in a flexible spending account (FSA). In my experience, you can use your flexible spending credit card to pay for massage. There may be some exceptions such as your card may not be accepted at the chair massage place in the mall/airport, a nail salon, or your home-based massage therapist. It may be accepted at a stand-alone massage facility, spa, and doctor’s office. The reason for this – without going into much detail – is business coding.
  2. If your FSA card doesn’t work then get an insurance receipt from the massage facility. By insurance receipt, I mean a receipt stating the service you received, duration, and cost. The receipt also has to state the name of the business and its tax ID number. Last but importantly, it needs to include the following billing code for manual therapy: 97124. Then send this to your health care provider. 
  3. If you are using massage for medical reasons, get a doctor’s prescription. This will make your claim much more valid. And submit this with the receipt to your health insurance provider. 
I’ve seen clients get reimbursed most to all their money back for the services rendered.

Try these steps a few times to see how your insurance company reimburses. Insurance companies are much more willing to work with their customers directly than they are with massage therapists. 

Massage is no longer a luxury, it’s a necessity. As we become more overwhelmed with daily stress and demand more of our bodies than ever before, we need massage to keep our muscles and bodies in good working condition. Where we may feel health insurances should cover massage therapy, the reality is the system is far away from the same conclusion. In the meantime, we have to coordinate our efforts to make sure massage therapy is available to us if we need it.

Leave a comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.