for Massage Therapy
by Clark Dougherty, L.M.T.
eople frequently ask me, “Will answer for this is to check your Marion County’s largest employer
my insurance pay for massage insurance information booklet or does cover medically necessary
therapy?” online service to determine if massage massage therapy. However, the
Before I answer, another question therapy is a covered expense. county’s largest manufacturer does not.
must be asked. “Do you mean, It depends on what the insurer
PIP from an auto accident, or and insured company negotiate
Worker’s Compensation coverage for covered services. Please note
from an existing claim, or that physical therapy and massage
employer group insurance or therapy are two different medical
private medical insurance, or services. A prescription written for
Medicare?” If your massage physical therapy will not be
therapist will create proper honored by a massage therapist,
medical records, coordinate and vice versa.
therapy with your medical service Usually, an annual deductible
provider and directly bill the must be paid by the individual
insurer, then five answers are before insurance will reimburse
possible: either the individual or the
medical service provider.
1. PIP, or Personal Injury
Protection. PIP is required for all 4. Private Medical Insurance.
auto insurance written in Florida. This is just what it sounds like:
If you obtain a massage therapy medical service coverage bought
prescription from the treating by an individual or family. Just as
physician for the auto accident, for employer group insurance,
PIP will typically pay 80% to check your insurance information
100% of charges for massage booklet or online service to
therapy. The percentage depends determine if massage therapy is a
on the individual policy. It is covered expense. If you get a
always best to consult with the prescription from an authorized
adjuster assigned an auto accident medical professional including
case to determine both coverage your primary care provider or
and reimbursement rate for the chiropractor, and massage therapy
medical services provided. If you get a prescription from an is included as a covered service, it is
authorized medical professional eligible for reimbursement.
2. Worker’s Compensation. This is including your primary care provider Blue Cross/Blue Shield usually offers
a form of protection for work-related or chiropractor, and massage therapy is massage therapy as part of their covered
injuries. If you obtain a massage included as a covered service, it is services. However, they frequently set
therapy prescription from the treating eligible for reimbursement. a low maximum benefit per calendar
physician, and if you advise and get Blue Cross/Blue Shield is a prime year on non-traditional medical
approval from the “WorkComp” example of group insurance. They will services such as physical therapy,
provider, typically 80% to 100% of have established a reimbursement chiropractic or massage therapy. Check
massage therapy charges will be amount to pay for a specific medical your individual policy for coverage
covered. It is always best to consult service. Any charges beyond the and for maximum benefits limitations.
with the “WorkComp” carrier to verify reimbursement amount will be borne United Healthcare typically does not
coverage and rates for massage therapy by the individual. Usually a co- cover massage therapy.
services rendered. payment amount per visit must be paid As with employer/group insurance,
by the patient/client prior to services. the insurer will have established a reim-
3. Employer Group Insurance. This This is typical of all medical service bursement amount to pay for a specific
is medical insurance provided by your visits, whether to your doctor, dentist, medical service, any charges beyond the
employer or by an association of chiropractor, hospital, outpatient clinic reimbursement amount will be borne by
individuals in a “group.” The best or physical therapist. the individual, and a co-payment
amount per visit usually must be paid by massage therapy will be included as a your massage therapist whether he or
the individual prior to services. covered service. For now, though, if she is capable of and willing to provide
you are 65 or older you will not the extra effort insurance billing requires.
5. Medicare. Medicare is the receive reimbursement for massage And then, enjoy the benefits of massage
national medical services ”insurance” therapy unless you have a private therapy in your everyday life.
for retirees age 65 and older. Currently, insurance policy that isn’t connected to
massage therapy isn’t covered by Medicare coverage and your private Clark Dougherty is a Licensed Massage
Medicare. All secondary insurers who policy specifically lists massage Therapist (MA 27082) and has operated
sell supplemental Medicare policies therapy as a covered expense. his Therapeutic Massage Clinic
use the same tactic for denying (MM9718, insurance accepted) for 10
massage therapy to Medicare patents: PIP (auto accident) claims and years. Three LMTs work at the clinic
if Medicare does not provide coverage Workers Compensation claims will along with a licensed hypnotherapist
for a service, they choose not to cover usually cover massage therapy. For who is also certified in EFT. Clark is an
it also. So, a person who might have group health or private medical active volunteer at Ocala Civic Theatre,
had massage therapy benefits for their insurance, help yourself find the right where he has stage-managed a half-
entire working life will lose that answer. Research to discover whether dozen musical productions in recent
medical service as a reimbursed massage therapy is a covered expense in years and has run the sound board for a
service once they convert to Medicare. your own insurance policy. Ask your dozen more shows. His clinic phone
If national health care policies medical service provider for a massage number is 352-694-7255. Visit
change anytime soon, perhaps therapy prescription if it is needed. Ask www.ClarkDougherty.com.
Some of the Benefits of Therapeutic Massage
Massage works for chronic low-back pain Fakouri, C., Jones, P. Relaxation Treatment and Measurement. Med. J. Aust.
People who get massage for sore Rx: Slow Stroke Back Rub. J. of Geron. 161: 125-28; 1994.
muscles and pain say it gives them relief Nurs. 13 (2): 32-35; Feb 1987. Ferrell-Torry, A.T. and Glick, O.J.
and helps them get back to regular activity. Field, T., Morrow, C., Valdeon C., The Use of Therapeutic Massage as a
Recent research on the benefits of massage Larson, S., Kuhm, C., Schanberg, S. Nursing Intervention to Modify Anxiety
for some types of back pain has shown Massage Reduced Anxiety in Child and and the Perception of Cancer Pain. Cancer
that massage is effective in both relieving Adolescent Psychiatric Patients. J. Am. Nurs. 16 (2): 93-101; Apr 1993.
chronic low-back pain and for controlling Acad. Child Adolesc. Psychiatry. 31 (1): Palliat. Nurs. 1 (1): 21-30; Jan/Mar 1995.
some other back pain. Studies/resources: 125-31; Jan 1992.
Cherkin, D.C., Eisenberg, D., et.al. Meek, S.S. Effects of Slow Stroke Massage works to boost the immune system
Randomized Trial Comparing Traditional Back Massage on Relaxation in Hospice Your body’s immune system helps you
Chinese Medical Acupuncture, Thera- Clients. Image. J. Nurs. Sch. 25 (1): 17-21; fight off infections and illnesses, and it
peutic Massage, and Self-care Education Spring 1993. helps you recover from injuries. When you
for Chronic Low Back Pain. Arch Intern Shulman, K.R., Jones, G.E. The Effec- are under stress, the immune system may
Med. 161(8):1081-8; Apr 23, 2001. tiveness of Massage Therapy Intervention on not always work properly. Research among
Preyde, M. Effectiveness of Massage Reducing Anxiety in the Workplace. J. different groups of people in very different
Therapy for Subacute Low-back Pain: A Applied Behav. Sc. 32(2): 160-173; Jn 1996. situations has shown that massage can
Randomized Controlled Trial. CMAJ. increase the immune system’s cytotoxic
162(13):1815-20; Jn 27, 2000. Massage works for cancer patients capacity (the activity level of the body’s
Cancer and cancer treatments can natural “killer cells”) and decrease the
Massage relieves stress and aids relaxation cause physical pain and anxiety. Women number of T-cells. The result is an immune
After a massage, people say they “feel who have mastectomies report negative system that is working better. Studies/
good” overall. They also report a greater feelings about being touched and must resources:
sense of well being. When someone “feels fight a common problem of lymphedema Field, T., Hernandez-Reif, M.,
good,” they usually hurt less, too. Massage (a buildup of lymph in the arm after their Ironson, G. Massage Therapy Effects on
has been shown to reduce blood pressure surgery). Massage has been shown to Breast Cancer. (unpublished); 1998.
and heart rate, and to increase blood and reduce and relieve lymphedema, to relieve Ironson, G., Field, T., et.al. Massage
lymph circulation. Massage also has been pain and anxiety among hospitalized Therapy is Associated with Enhancement
shown to increase endorphins, the body’s cancer patients, and to help mastectomy of the Immune System’s Cytotoxic
natural pain killers. Studies/resources: patients recover from their reluctance to Capacity. Intern. J. Neuroscience. 84:205-
Cady, S.H., Jones, G.E. Massage be touched. Studies/resources: 217; 1996.
Therapy as a Workplace Intervention for Badger, C. The Swollen Limb. Nurs. Zeitlin, D., et.al. Immunological
Reduction of Stress. Perceptual and Motor Times (England). 82 (31): 40-41; 1986. Effects of Massage Therapy During
Skills. 84(1): 157-158; Feb 1997. Brennan, M.J.and Weitz, J. Lymphe- Academic Stress. Psychosomatic Medicine.
Culpepper-Richards, K., Effect of a dema 30 Years After Radical Mastectomy. 62:83-87; Jan/Feb 2000.
Back Massage and Relaxation Intervention Am. J. Phys. Med. Rehabil. 71: 12-14; 1992.
on Sleep in Critically Ill Patients. Am. J. Bunce, I.H., Mirolo, B.R., Hennessy, —American Massage Therapy Association
Crit. Care. 7(4): 288-299; Jul 1998. J.M., et. al. Post-mastectomy Lymphedema (www.amtamassage.org).