How to get medical insurance to cover massage therapy

For many people suffering from ongoing pain, massage therapy is an important component of their treatment plan.

It’s become especially important to recognize massage as a pain-relief method as the country faces an epidemic of opioid abuse. Doctors and patients are turning to alternative methods, which include non-opioid medications and therapeutic massage.

But when it comes to massage, how can you be sure that your health insurance provider will cover it?

There’s no guarantee that every insurance provider will cover massage therapy, but these tips can help:

1. Call to verify your insurance coverage for massage therapy

There are some important questions to ask your insurance company. Contact a representative through the customer service number (usually on the back of your insurance card).

Example questions:

• I’ve received a prescription for medical (or therapeutic) massage written by my medical doctor. How do I know if it’s a covered service in my plan?
• Does my prescription for massage need to have a particular diagnosis (such as “back pain”) or diagnosis code number (such as “M54.6”)?
• What else needs to be included in my prescription, and what kind of doctor needs to prescribe this for me?
• Will my plan cover my diagnosis of “back pain”? (This applies if you already have a diagnosis from your doctor.)
• Do I have any limitations on the number of visits or length of time for each visit? (If your insurance representative says each visit is limited to a certain number of “billing units,” ask how long each unit lasts.)
• Where can I schedule a massage that is in-network with my plan? Is the licensed massage therapist in-network with my plan only at that location or facility?

2.  Get a prescription by clearly communicating to your doctor that you’d like massage therapy

Say you’re having muscle pain and, based on your lifestyle, pain history and research, you think massage therapy is a reasonable option. Describe all of this clearly to your doctor.

For example: “I have low back pain, and it may be because I’m sleeping a certain way, but I’m not sure. I’d like to try massage therapy based on what I’ve read about its benefits for acute pain, and I’d like a licensed massage therapist to help me figure out why it’s happening and correct it. If it doesn’t improve, then I’d like to talk about pain medication options. Would you recommend this for me?”

Depending on your situation, your doctor likely will be open to prescribing massage. Licensed therapeutic massage is safe and non-addictive, and medical research consistently supports its effectiveness as a pain-management treatment.

3. Ask your doctor to prescribe massage for the most general diagnosis possible

A prescription of massage therapy for “muscle pain” allows a licensed therapist to adjust treatment to your problem more easily and quickly.

For example, you may have pain in your left ankle, but it later turns out that your ankle pain resulted from lower back pain you’ve been compensating for over time.

Because massage therapists can’t write prescriptions or diagnose patients, they must do exactly what the prescription asks. If your prescription specifically asks for massage in the area of your left ankle, a massage therapist won’t be able to begin treating your lower back unless you obtain an updated prescription from your doctor.

4. If possible, get a prescription that doesn’t specify the frequency and number of massages

A prescription that says exactly how many massages are needed or how many you should receive each week doesn’t always lead to the best treatment plan.

When licensed massage therapists meet with patients, their goal isn’t just to offer therapy, but also to identify how the person came to have this pain. They’ll evaluate habits, such as crossing the legs a certain way, that could be adjusted to prevent pain. 

There may also be a cause that a patient won’t want to change – maybe their cycling posture contributes to back pain, but they love cycling and don’t want to stop. At that point, massage therapy becomes regular maintenance for the patient. In these scenarios, the problem is difficult to fix in a limited number of appointments.

Getting in for an appointment at the times dictated in a prescription also can become difficult between therapist and patient schedules, or if there is a gender preference in therapist that needs to be accommodated.

Massage therapy may be the key to reducing pain for you, whether you’re suffering from muscle aches, arthritis, headaches or even fibromyalgia. Licensed massage therapists can contribute to your physician-managed treatment plan and help you learn better self-care strategies.

Caitlin Merriman, a licensed massage therapist, is the program manager for Massage Therapy at Ohio State Integrative Medicine.