Does Medicare Cover Massage Therapy?
Find out what parts of Medicare cover massage therapy and learn about the options you have to help pay for out-of-pocket expenses.
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Key Takeaways:
Medicare does not consider massage therapy to be medically necessary. As a result, it is not covered.
Some forms of therapy are covered under Medicare Part A and Part B.
Confirm that your provider takes Medicare assignments before starting therapy.
Some Medicare Advantage plans cover massage therapy. Check with your provider to confirm the terms of coverage.
If your doctor recommends massage therapy, you may wonder whether it is covered by Medicare. Original Medicare does not cover massage therapy.
This is because massage therapy is considered an alternative treatment. Medicare Part A and Part B only cover medically essential services. However, physicians may recommend massages and other forms of therapy to manage chronic conditions such as:
If you're looking for alternative coverage, some Medicare Advantage plans do cover massage therapy.
It is therefore worth looking at what therapists charge. On average, massage therapy costs about $60 per hour. This price can vary by region, gratuity, and type of massage. Some types target specific muscle groups while others promote relaxation.
Medicare Provides Access to Approved Therapy
Medicare Part A and Part B do cover medically necessary forms of therapy.
Part B benefits cover outpatient therapy under certain conditions. For Medicare to consider your therapy as "medically necessary," the service has to:
Meet accepted medical standards
Help treat an injury, disease, or symptoms
Some Medicare-approved therapy forms include:
Physical therapy to help manage pain
12 acupuncture sessions in 90 days to treat chronic low back pain
Chiropractic services to cover spine manipulation when medically necessary
Outpatient occupational therapy
Outpatient speech-language pathology
Part A Therapy Costs
In certain cases, your doctor may recommend inpatient rehabilitation care. Your Part A benefits would cover physical therapy, occupational therapy, and speech-language pathology as needed. In this setting, you would receive coordinated medical care to help you recover from major surgery, illness, or injury. Your Medicare costs for inpatient rehabilitation would be:
$1,364 deductible for days 1-60
$341 daily coinsurance for days 61-90
$682 daily coinsurance for days 91 until you exhaust an additional 60 days in your lifetime
Your deductible costs apply for one benefit period. This period starts when you first get hospitalized. As soon as 60 days elapse without receiving more inpatient care, your benefit period ends. This 60-day period takes into account prior hospitalization in different institutions such as a hospital.
Part B Therapy Costs
If you receive approved therapy services, you would pay:
20% of the approved Medicare charges
Part B deductible starting at $198 in 2020
Talk to your provider to confirm that they accept Medicare assignments before starting treatment. In some cases, your provider may request more tests. You want to follow up with your insurance if your doctor recommends more sessions than Medicare covers.
Be sure to hold on to your records until your insurance processes your care. Charges that are not covered will be your sole responsibility.
Does Medicare Advantage Cover Massage Therapy?
In addition to basic Part A and Part B, Medicare Advantage plans may provide extra benefits including massage therapy. While Original Medicare is federally managed, private companies sell Medicare Advantage plans.
The Centers for Medicare & Medicaid Services (CMS) encourages Medicare Advantage plans to include massage therapy as part of non-opioid pain management. According to CMS, 270 plans started providing therapeutic massage services to 1.5 million enrollees in 2019.
If you have a Medicare Advantage plan, check with your provider to find out what therapy is available to you. This is because benefits and conditions vary by plan.
Generally, Medicare Advantage plans may cover your massage therapy if ordered by a physician. The purpose cannot be relaxation, but to help treat injury or illness.
Additionally, your massage therapy must be provided by a state-licensed massage therapist with a registered National Provider Identifier. Patients usually get referred for massage therapy after suffering from an injury or illness. As an impact of this injury or illness, patients may have:
Chronic pain
Stiffness
Poor range of motion
If you have additional questions about what services are covered by your Medicare plan, you can look up the Medicare.gov search tool. You should also connect with a licensed health insurance agent and discuss potential plan options that best fit your health and budget needs.
Grace Kisirkoi works in higher education and is a writer who specializes in finance.
