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Getting massage covered by health insurance

Getting massage covered by health insurance is always a hot topic.  Many MT want to stay out of the healthcare business and not get into working with insurance and the medical profession claiming that it takes the 'art' out of doing massage.  The medical profession and insurance companies are seen as places that will eat massage therapists for breakfast!

On the other hand, getting massage covered by health insurance in every state can help the profession become more of a profession.  Getting health insurance to pay for massage can help more people when they are injured and sick or in pain.  (It doesn't cover relaxation massage or preventative massage -or at least not yet.)   When people come in with an injury or some kind of condition, they usually come regularly - like once or twice a week depending on the condition.  They come for the amount of time it takes to get them better.  Massage can help with many conditions like carpal tunnel syndrome, fibromyalgia, back and neck pain, knee and foot pain, strains and sprains.  Most of these people would not come for massage unless it was covered by insurance. 

I have been lucky to be in WA State where we can become contracted providers and bill insurance when medically necessary.  It hasn't always been easy, but it has been a steady stream of clients for me over 24 years.

When you bill insurance, you will also need to be doing chart notes to show the progress that clients make with your massage sessions.  For the most part, doctors and insurance companies are still very unaware of what massage can do.  The insurance companies also do not realize that it can save them money.  They currently see it as an additional expense. Someone will go for massage sessions for their back pain in addition to the back surgery they will get from the doctor.  Most do not understand that massage therapy can often eliminate the need for the surgery! 
That was one of the biggest issues here in WA where we are contracted providers with health care insurance companies. When the law was created by our insurance commissioner at the time - Deborah Senn - the insurances fought the law because they did not realize that it was not an expense but it could be a savings.  Deborah Senn has talked about how the law came about here at the Massage Therapy Foundation Research Conference in Seattle in 2010 and at the AMTA Convention in 2011.  It really was a matter of her believing in massage and also having a very politically active massage therapist - Lori Belinski (who now works for the chiropractic association here in WA).  That is all it took was someone standing up for the massage profession and it can happen in any state.

Now every state has that opportunity. The Affordable Health Care Act is the health care reform act of 2010 created by the Obama Administration.  Whether you like the act or not is not the issue here.  What matters is that massage therapists now have the opportunity to get massage covered by health insurance companies in each state.  What is happening as far as I know right now is that each state needs to decide if they will create their own health insurance exchange system or use the Federally set up system.   Part of the Affordable Health Care Act has a provision that will allow massage therapists to get into healthcare.

(Section 2706) States: "A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law.


That means every health care provider!
That means Massage Therapists!


(This is similar to the law we have in WA that allows us to be contracted providers with health insurance.)

Right now it is important to start getting involved in your state and figure out what is happening.  Start with contacting your State AMTA Chapter.  They often are more up on politics in each state.  Contact your insurance commissioners office and find out how they are implementing the law in your state and find out how to get Massage Therapists involved and to be a part of this. 

I encourage all massage therapists do to this -whether or not you want to bill insurance or not.   All it takes is standing up for the massage profession.  Who will stand up for us?  

IF YOU ARE NOT AT THE TABLE, YOU WILL BE WHAT IS ON THE MENU!  (from Jan Schwartz and John Weeks of the Academic Consortium for Complementary & Alternative Health Care).   If we don't stand up and get to the table on this, someone else like the PT's, MD's or Chiropractors will do it for us and I don't think we really want that!  Or the insurance companies will do it themselves.  Who do you want to be in charge of our profession?


When you find out what is going on in your state, please share the information either here or on my new forum -  That way we can keep track of what is going on where and share in this effort to become part of healthcare and become more respected by doctors, insurance companies and the general public.

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Comment by Gordon J. Wallis on August 12, 2012 at 11:44pm

Now dont get me wrong...There are chronic people out there that would definitely find massage soothing and helpful..  What would qualify someone to have their massages covered by insurance?

Comment by Gordon J. Wallis on August 12, 2012 at 9:07pm

Maybe I dont know what you are talking about?  When I billed insurance companies I was working in chiropractic offices and in Physical therapy clinics... And it was all auto accident and work related injuries... And also related to this discussion... I was in the mall  a while back and one of my clients recognized me.. And said I need to get another massage with you soon...and another lady overheard and said...OH Are you a massage therapist... I said yes....she said.. How much does it cost... I said $95 for one hour...She said Oh my goodness thats too expensive...I just go to my chiropractor and its for free.... so in other words...for her its just a free massage.....She medically doesnt need a massage..To me thats insurance fraud.... If someone is hurting , and they are paying for the massage..You have to fix(help) them, and do it fast and efficiently....Thats just not going to happen in the insurance business... I could go on and on about this...  I made a lot of money...Lots....But, its just better for me with a cash practice now...And if people are paying out of pocket...You gotta help them fast, or they go somewhere else...I fix em fast now...And the ones I cant...They move on or need more specialized advanced medical intervention  You said it was a hot topic...and thats why..Im really happy outside the system.   And its ok if other therapists think otherwise...Im just commenting on the topic .. it could be a good thing?  Just not my experience.

Comment by Gordon J. Wallis on August 12, 2012 at 5:21pm

I billed insurance companies for over ten years...I had to fit into a treatment plan submitted by a 1st tier provider....All Im going to say is.. You don't fit well into those treatment plans when you completely fix them in one or two sessions...And you never fix them when the patient is suing..   There is so much money involved..Its corrupt.   I suppose if you can bill directly without a referral or be a part of someones treatment plan   Then yea no problem...    Im just talking from my experience..   Not trying to argue with anyone....

Comment by Julie Onofrio on August 12, 2012 at 1:02pm

That just isn't true any longer.  You can easily stay a 'healer' and help many more people when you get into the system.  It is easier to bill and takes less time and energy now with online billing, online medical records, being able to verify benefits and see claims online.  You can be just as effective in the insurance world and the more massage therapists that do get involved (and all of their clients) the louder and stronger our voice will be.

Comment by Gordon J. Wallis on August 3, 2012 at 11:24am

Massage works much better outside the insurance system....No doubt what so ever in my mind...Ive been in this profession 28 years....Ten of it billing insurance companies exclusively..  When massage fits into a dysfunctional system, it becomes dysfunctional.  I'm able to help the vast majority of people(clients) very quickly and cost effectively outside the insurance system.  If cant help them within a couple of sessions...Then they need to go to a medical doctor, and perhaps then into the insurance system... I will stay independent, free, and outside the insurance system in order to be an effective massage therapist...I feel much more comfortable being the alternative. Im a healer now.. In the system you're a hot pack or a tens unit.  Even though you get a lot of money.

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