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Home blog Why You Need A Doctor’S Prescription For Massage Therapy When…
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As a provider of massage therapy for the treatment of injuries related to work or automobile accidents , I often receive calls from injured individuals seeking my company’s services.
Sometimes these patients will have already seen a doctor and been referred for massage therapy. Other times, either an individual has not yet been fully evaluated for injuries, or has already seen a doctor but did not receive a prescription specifically for massage therapy.
The number one reason why it is imperative that new patients seeking massage through their auto insurance or work injury claim obtain a prescription first is that Licensed Massage Therapists (LMTs) are by law not allowed to diagnose any illness or disorder . This is an important distinction between LMTs and some other healthcare providers like doctors (MD / DO), physical therapists (PT), and in some cases chiropractors (DC) who can diagnose and prescribe therapies.
Physicians are getting more and more comfortable prescribing massage for a variety of injuries and other health conditions. (To learn about what kinds of insurance policies cover massage please see my related article here ).
It is also important for physicians to be as specific as possible when writing out the order for massage. For example, in order to properly submit the paperwork to the insurance company, the documentation must include “diagnosis codes” . Since the LMT can’t diagnose anything, if the physician does not include these codes, the therapist will have to try to contact the doctor’s office to get them before submitting any bills.
It is also helpful when the doctor indicates the frequency of massages prescribed . Some people may only need once or twice a week for a month, while other injuries may call for multiple weekly sessions for several months.
Working with a reputable massage provider experienced in dealing with physicians and insurance companies will help to make the process of obtaining prescribed massage therapy through insurance a painless one. For further information please read this related article on how to choose the best injury massage provider .

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Identify a condition or injury that can benefit from medical massage. In order to prove medical necessity for a massage, you must have a recognizable health condition that may respond to massage in a positive way. [1]
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Check insurance rules. Before proceeding with a request for a physician referral for a massage, check to see what the actual rules are for your insurance policy. [2]
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Consider whether or not a referral will result in coverage. Often, even if you have a referral, other coverage limitations may apply. Read the policy document thoroughly to make sure that this is not the case.
Understand any exclusions or limitations specifically mentioned in the policy. Another stumbling block for getting medical massage covered is when it is included in exclusions, along with chiropractor visits and other specific types of treatment.

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Talk to your primary care provider. In many HMOs and other health plans, this doctor is the one who must authorize the referral. [3]
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Discuss medical necessity with the doctor. Figure out how that medical professional will diagnose a condition that can formally necessitate medical massage.
Ask the doctor about what kinds of other treatments go along with medical massage. One way to get a better chance of successful coverage is to combine medical massage with other types of treatments. Ask about how a holistic treatment plan can help provide better rehabilitation or recovery while legitimizing the use of medical massage within a greater context.

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Obtain a referral. Make sure that the primary care physician's office releases the referral, either to you or directly to the specialist and the insurance company.

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Keep records carefully. If the insurance company comes back in the future to ask for the referral or other facts such as a date range, keep that document on file to be able to provide that information and streamline any coverage or eventual payment by the insurance company.

Medicare does not cover massages performed by a massage therapist. However, you may be able to get massage therapy from a physical therapist or chiropractor.

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The art of massage is, to many, more than a way to relax or de-stress the body. For millions of people suffering from joint or muscle conditions or a range of other illnesses, massage can be an effective type of treatment. One potential problem lies in the setup of many national health systems, where massage is not formally considered an effective medical treatment. Insurance companies often consider massage to be an elective treatment that has no medical necessity. As a result, visits to a massage therapist will often not be covered by medical insurance. One exception is when the patient succeeds in getting a referral from his physician to go to a massage therapist. For those who want to get a physician medical massage referral with the goal of getting massage visits covered by insurance, some critical steps apply.

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