Insurance Coverage for Massage Therapy in Seattle

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.

The word functional means that there has to be a loss of function due to the condition and that massage must be able to restore function.

Therefore, insurance does not cover massage for stress relief, soreness due to exercise or things like that.

Please check with your insurance company to get your definition of medically necessary as the definitions will vary with each company. Please download and fill out this Insurance Verification form (pdf) and bring it in with you to your first appointment along with your insurance card and prescription.

I am an insurance provider for Aetna, Uniform Medical, Regence Blue Shield and Premera Blue Cross. 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.) 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.

* Is massage therapy covered?
* How many sessions are allowed each year?
* What is my copay or what percentage of the fee am I responsible for?
* Do I need a prescription from my Primary Care Physician or can it be from my chiropractor, Acupuncturist or other health care provider?
* Do I need a referral? Regence Blue Shield Selections plans need a referral from the insurance company. You doctor will need to call it into the insurance company and the insurance company will send me a notice.
* Will insurance cover massage for this condition that I have?

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. More info: motor vehicle accidents and massage.

If you are not with one of the companies I mentioned above, your insurance may have out of network benefits meaning you don't have to see someone in their network. You need to call your insurance company to find out if you do have those benefits and ask the same questions above and what benefits are allowed.

If you have any questions about billing your insurance company for massage therapy services, please contact me at the phone number below.