Massage is a popular way to relax, and under certain circumstances, massage therapy to treat certain medical issues may be covered under Medicare.
Massage therapy for medical issues can require many treatments making the cost of sessions prohibitive for some people, especially for people who have fixed incomes or who are Medicare beneficiaries. According to the University of Minnesota, the average cost of a massage therapy session is approximately $60 per hour.
In the interest of increasing your understanding of how the Medicare program and Medicare Supplement Plans respond to massage therapy, we’ll explain the following topics:
- Medical reasons for needing massage therapy
- Circumstances that Medicare will pay for massage therapy
- Circumstances where Medicare won’t pay for massage therapy
- Examples of how Medicare responds to massage therapy services
Medical Reasons for Needing Massage Therapy
Massage therapy involves a massage therapist who uses various techniques to stimulate the body’s tissues.
The various types of massage therapy are deep tissue massage, Swedish massage, acupressure techniques, and therapeutic touch, to mention a few.
This is a popular form of treatment because of the multiple health advantages it provides and because it’s a non-invasive form of treatment.
Here is a partial list of the benefits of massage therapy:
- Improves circulation
- Reduces swelling
- Increases range of motion
- Relieves muscle spasms
- Relaxes the body
- Decreases anxiety
- Produces endorphins (natural chemicals in the brain that improve mood)
Medical professionals often prescribe massage therapy to treat various medical diagnoses including arthritis, fatigue due to cancer treatments, sleep disorders, diabetes, back pain, depression, and more.
Massage therapy can also reduce pain for people with chronic physical diseases and decrease the physiological burden of stress.
As effective as massage therapy can be for certain conditions, it comes with a cost that can be challenging for some to pay.
Can You Pay for Massage Therapy with Medicare?
Whether you can pay for massage therapy with Medicare or not depends on several factors.
Medicare will pay for massage therapy if a physician deems it medically necessary as a therapeutic intervention and it’s part of the rest of the care plan. This means a Supplement plan will pay too. The massage provider must support the need for more than the standard number of massage treatments by providing documentation to Medicare.
Medicare also requires massage therapists to be qualified as licensed physical or occupational therapists. The Medicare rules also allow physical therapist assistants and occupational therapist assistants to provide massage therapy sessions as long as they’re supervised by a licensed physical therapist or occupational therapist.
As for massage therapy for non-medical purposes and services that aren’t prescribed by a physician, individuals must pay for them out of pocket or with other forms of health insurance.
Massage Services That Aren’t Covered Under Medicare
While Medicare will pay for massage therapy sessions under certain circumstances, there are also circumstances where Medicare won’t pay for services.
For example, massage therapy isn’t covered under Medicare as an isolated treatment. Also, certain types of services massage therapists perform aren’t covered by Medicare such as roller beds, aqua-massage tables, and massage chairs.
Lastly, Medicare won’t pay for massage therapy solely because you want it or feel as though you need it.
Examples of How Medicare Responds to Massage Therapy Services
A couple of examples will help to make clear how Medicare views massage therapy services.
Example #1
A 67-year-old man who has Medicare fell off a ladder and injured his back. His physician prescribed six sessions of massage therapy as part of his treatment plan, and they were paid for by Medicare.
If the man wished to continue massage therapy for another month to prevent his symptoms from returning, he would have to pay for them out of his pocket.
Example #2
A 68-year-old woman who has Medicare had been experiencing acute back pain making it difficult for her to perform everyday tasks such as vacuuming and carrying laundry baskets. Her doctor prescribed a few sessions of massage therapy to reduce her pain sufficiently so she could participate in physical therapy. Medicare would cover the cost of massage therapy as it was part of her overall treatment plan.
Final Tips for Getting Coverage for Massage Therapy Under Medicare
If you’re interested in getting massage therapy covered by Medicare, you need to be aware that the services must be prescribed by a physician, and they must be part of an overall treatment plan. Also, massage therapists must be licensed physical therapists or occupational therapists or be supervised by one. Finally, be aware that not all massage services are covered under Medicare.
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