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Andrew Wolfe, LMP, MMS | Article

Medical Massage and Insurance Coverage

4/27/2012
Medical massage therapy is the ability to heal, restore and improve function which was otherwise compromised due to illness, injury, disease or surgery. Medical massage therapy is recognized as a health care provision under rehabilitation outpatient coverage under most major medical plans. Specific coverages vary according to your individual insurance plan. Usually, medical massage must be a part of a treatment plan your primary care provider recommends as medically necessary to restore lost function. Provisions are also given towards motor vehicle accident (PIP) and worker's compensation-labor and industry (L&I), job injury recovery care claims. Likewise, verification and preauthorization must be met prior to starting care.

The variety of techniques and application of massage therapy are vast, and depend on the training and experience of the licensed massage therapist. State laws are in place for licensing and certification. When seeking out care, it’s always good consumer judgment to seek the massage therapist with the most education and experience. If you are injured you should seek out a massage therapist with the skills, training and experience compatible with your injury. For instance, you would not want to seek out a massage therapist who specializes in spa massage. Injury treatment is specialized and has specific protocol and training, whereas spa massage does not. Insurance companies will not recognize a "feel good" spa approach as a medical procedure. You should also ask about how the facility or practice is run, what kind of specialized training they have, and what kinds of clinical experience have they have in treating specific conditions. Your primary health care provider and local hospitals are good sources to find experienced massage therapists. There are also a number of organizations, such as the American Massage Therapy Association (www.amtamassage.org), that provide listings for certified massage therapists.

For the best results, practice self-education and consumer awareness, and have a proactive approach. Be a willing participant in your healing and recovery will happen.