Click to Schedule Online Now!

Insurance Coverage for Massage Therapy

I accept Regence Blue Shield and Premera Blue Cross.  I do not accept out of state Blue Cross/Blue Shield plans. 

Regence Blue Shield has specific requirements for getting massage covered.  Be sure you read the full page on this.  See more on exemptions and the Regence Massage Therapist pre-authorization process before signing up for your appointment.  Regence Uniform Clients are exempt from this, but a prescription is still required.

Premera Blue Cross:  All Plans require a prescription from your doctor, no matter what the insurance company says.  Some Premera Plans also require prior authorization.  Please read the page on Premera Blue Cross and Massage therapy before scheduling your appointment

All insurance claims must have a prescription from your doctor with a diagnosis in order to be processed, no matter what the insurance company says.  Insurance will only cover massage if there is an injury or condition that makes it medically necessary to get a massage. It does not cover massage just for stress. It does not cover maintenance or preventative massage. It does not cover soreness due to exercise. It will cover things like herniated discs, carpal tunnel syndrome, plantar fasciaitis and tennis elbow. Please call your insurance company to find out what your benefits are. Ask for the medical necessity definition.

 Your Health insurance may cover your massage therapy services if you are dealing with a specific injury or condition that can be resolved or improved by getting massage therapy - in the insurance companies words it must be "medically necessary" and the massage sessions must show improvement in your condition.

Medically necessary treatment is usually defined something like this:

"Massage therapy may be considered medically necessary when performed to meet the functional needs of a patient who suffers from physical impairment due to disease, trauma, congenital anomalies, or prior therapeutic intervention. Maintenance programs are considered not medically necessary."

My personal guidelines are massage must be done once a week for a few weeks to assess and determine if massage can help your condition.  You can not come once a month or once every few months just because you want to.  Massage must be able to help resolve your condition.  Insurance does not cover maintenance massage or massage for preventative/wellness.  It must be for only a medical condition. It works more like physical therapy in that there is an end date.

Please check with your insurance company to get your definition of medically necessary as the definitions will vary with each company and to find out what your policy allows for as far as getting massage therapy. Please download and fill out this Insurance Verification form (pdf) and call your insurance company to find out what your massage benefits are. Also bring the filled out form with you to your first appointment along with your insurance card and prescription.

I am an insurance provider for Regence Blue Shield and Premera Blue Cross/Lifewise.I do not accept Blue Cross/Blue Shield plans from other states.

Special Regence Blue Shield Pre-authorization requirements: 

Massage Covered Services

Massage Therapy for injury or illness for which massage has a therapeutic effect. Coverage is provided for up to a 60 minute session per visit when rendered by a participating massage therapist. Covered Services include but are not limited to acupressure,deep tissue massage, or as allowed by the massage therapists license.

Massage Therapy is considered medically necessary when all of the following circumstances have been met:

  • Significant lasting therapeutic benefits lead towards a resolution of the member’s subjective complaints
  • Functional limitations have improved significantly as a result of massage therapy treatment
  • Treatment is safe and effective and is not replacing or delaying other necessary medical care
  • Patient should have at least one (1) Functional Limitation as follows: Sitting, Standing, Walking, Stair climbing, Lifting, Working, Personal care (washing, dressing, etc.), Driving, Sleeping
  • Patient should have at least one Subjective Complaint, as follows:Neck pain, Shoulder pain, Upper arm pain, Forearm pain, Wrist/hand pain, Upper/mid back pain, Low back pain, Hip pain, Upper leg pain, Lower leg pain, Ankle/foot pain.

You will need a prescription from your doctor stating the diagnosis of your condition along with their recommended treatment plan (the number of sessions per week and how long sessions should continue for.) The number of sessions prescribed begins on the day the prescription is written so a current prescription will always be required. For example: if your doctor wrote a prescription for 6 massages, 1x a week for six weeks, that begins on the day they write it. You can not come in 6 months later and get the prescription filled.

Some insurance companies require that you pay a copay or a coinsurance payment. You can call your insurance company and ask them these questions or feel free to call me with any questions and I will try to help you as best I can.

If you have been in a Motor Vehicle accident, massage may be covered by your auto insurance Personal Injury Protection Coverage. As with any covered service, a prescription from your doctor is necessary. You will need to bring me your claim information including the claim number, billing address and claim representative. 

If you have any questions about billing your insurance company for massage therapy services, please contact me at the phone number below. Please feel free to schedule online if you have your prescription ready and your claim information or insurance information.