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Medicare Massage Therapy Coverage and Eligibility

Does Medicare Cover Massage Therapy?

No, Medicare does not cover massage therapy unless it is part of a covered physical therapy treatment plan and is not billed as a separate service. However, Medicare Advantage plans may offer extended benefits that include massage therapy with less strict criteria for Medicare coverage.

Massage therapy can help alleviate symptoms of chronic pain, anxiety, and depression, and can also facilitate recovery from injuries. Learn more about how Medicare covers massage therapy.

Massage Therapy Is About More Than Relaxation

Though massage therapy is widely used to promote relaxation by alleviating soreness, it also offers medical applications in a healthcare setting. Massage therapists can manipulate the body’s soft tissues to reduce chronic pain and help heal injuries.

Clinicians and physical therapy professionals may recommend massage therapy in conjunction with other medical treatments.

But typically, massage therapy is not covered by Medicare.

Therapeutic massage practitioners, including osteopaths and occupational therapists, may refer patients experiencing bodily pain or stiffness to a massage therapist. Massage therapy can also provide non-invasive pain management solutions to seniors, especially those susceptible to medical conditions that tend to intensify with age, such as arthritis, osteoporosis, and high blood pressure.

For this reason, Medicare beneficiaries may want to better understand the very limited way Original Medicare covers this type of massage treatment, as well as how Medicare Advantage may offer wider massage therapy benefits.

Limitations On How Original Medicare Covers Massage Therapy

Original Medicare does not cover massage therapy, even if it is deemed medically necessary by your physician. However, to cover massage therapy, there is one exception: Medicare may cover massage therapy if it is part of a larger physical therapy rehabilitation or treatment plan where massage therapies are only a portion of the services rendered.

In this case, covered Medicare will pay for 80% of the approved cost of your physical therapy after you have met the Medicare Part B deductible ($226 for 2023). For example, you may have suffered a back injury and now struggle to move. Your doctor may deem that physical therapy is medically necessary to help you regain strength and independence. 

Your appointed physical therapist may then create a program that can cover massage therapy. Medicare coverage may be available for every therapy session that includes strength training, movement exercises, and some hands-on therapy.

Original Medicare covering therapists helps pay for your physical therapy costs under its Part B medical insurance coverage. This means that in this example, it would also cover this particular usage of massage therapy. However, if the hands-on therapy portion of your physical therapy plan is billed separately, massage therapy coverage is not guaranteed and you may be responsible to cover  the full cost of that service.

How Does Medicare Advantage Cover Massage Therapy?

Medicare Advantage (Part C) is the better solution for those looking specifically for massage therapists and massage therapy coverage. Medicare Advantage plans are offered by private insurance companies, and many offer additional covered benefits that Original Medicare does not. This typically includes dental, vision, and prescription drug coverage.

Exact Medicare coverage benefits vary by insurer and plan, but some Medicare Advantage plans include coverage for hands-on therapy to help you manage a condition or injury. Even though typically Medicare doesn’t cover massage therapy. 

Medicare coverage benefits are not standardized. Always make sure to review your plan’s policy details or speak with a trusted agent to see if your plan offers this coverage, or find one that does if this is a treatment you need.

Eligibility

Though criteria to cover massage therapy differs by insurer, you would typically need to meet the following requirements to have massage therapy covered:

  • Have a medical professional deem it medically necessary to help treat a condition or injury
  • Seek treatment from a licensed massage therapist within your Medicare Advantage plan’s network who offers medical massages

How Much Would Massage Therapy Cost With Original Medicare?

Original Medicare
Deductible
$226 for Part B
Copay
None
Coinsurance
You pay 20% of Medicare-approved costs

If your medically necessary physical therapy regimen includes massage therapy, you can expect to pay $226 to meet your Part B deductible and then 20% of the final Medicare-approved cost of the service. However, if the massage therapy portion of your physical therapy program bills separately, Medicare may not cover it at all, leaving you to pay 100% of the bill.

How Much Would Massage Therapy Cost With Medicare Advantage?

If you have Medicare Advantage, costs could vary based on your plan’s out-of-pocket expenses and coverage of massage therapy. For example, if your plan covers medically necessary massage therapy or therapeutic massage, you may only have to meet your Medicare coverage deductible and pay a copay for each session until you meet your plan’s out-of-pocket maximum.

Medicare-covered Alternatives to Massage Therapy

Usually, Medicare doesn’t cover massage therapy and Original Medicare only narrowly covers massage therapy,. Medicare beneficiaries may want to seek alternative or complementary treatments. Physical therapy, chiropractic therapy, alternative therapy, and acupuncture are among the most common therapeutic and preventive services covered by Medicare insurance.

Physical Therapy

Physical therapy can help patients resolve issues, including illness, injury, or disability, affecting their routine body function and movement. Medicare Part B covers 80% of the costs of outpatient physical therapy, provided a doctor certifies that it is medically necessary. Medicare beneficiaries must meet their Part B deductible before coverage kicks in.

Chiropractic Therapy

Chiropractic therapy is similar to therapeutic massage and involves the manual adjustment of the skeletal spine by a therapist to relieve pressure and sciatic pain. This is especially beneficial for people suffering from pain in the upper and lower back, neck, and shoulders.

Medicare Part B covers 80% of chiropractic costs once the recipient has met their annual Part B deductible; however, chiropractic therapy coverage is strictly limited to minor manual manipulation and does not include tests, x-rays, or referrals for supplemental treatments.

Acupuncture

Acupuncture involves inserting thin needles into strategic points on the body, enabling a re-balancing of one’s qi or flow of energy. It may also be effective in stimulating nerves and muscles, leading to pain relief. Medicare Part B covers up to 12 acupuncture sessions in a 90-day period, but only if used to treat chronic lower back pain. Patients who show improvement may continue treatment for a maximum of 20 visits in 12 months. Patients pay 20% after meeting their covered Medicare Part B deductible.  

How to Find Affordable Massage Therapy

If you still need massage therapy, there are options to help reduce the cost of treatment:

  • Book an appointment at a massage school. Massage schools for those seeking licensure may offer lower rates for massages for practicing students. You may find local schools that specialize in hands-on therapy for the specific condition or pain you wish to treat.
  • Keep an eye out for promotions. Many massage studios offer promotions throughout the year for therapies where patrons may book a massage for a discounted price.
  • Participate in a clinical study. You may find clinical studies that investigate the efficacy of hands-on therapy treatments for certain types of conditions without needing Medicare coverage. These trials may be free or even paid.

What This Means For You

Those looking for massage therapy coverage should consider Medicare Advantage plans that offer this benefit, as Original Medicare rarely covers this service. Hands-on therapy can be a valuable tool in managing a wide range of health conditions for Medicare beneficiaries, both physical and mental. It is important to consult with a healthcare professional to determine if massage therapy is an appropriate treatment option for a specific health concern.

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