Updated: November 14, 2025
Reviewed by: Dr. Donald L. Aivalotis, II
This guide explains whether Florida Blue covers massage therapy, including medical necessity rules, coverage limitations, provider requirements, and pre-authorization criteria.
Is Massage Therapy Covered by Florida Blue?
Sometimes — but usually only when it is billed as a medically necessary physical therapy service, not as a stand-alone massage.
Florida Blue does not treat massage therapy as a general wellness or spa benefit. Instead, massage is typically covered only when it is billed under the physical therapy code CPT 97124 (massage, including effleurage, petrissage, tapotement) and delivered as part of a documented physical therapy plan of care.1
In some Florida Blue-administered plans (for example, state employee PPO plans), massage therapy requires a prescription from a physician, advanced registered nurse practitioner, or physical therapist that documents medical necessity and specifies the body area to be treated.2
Massage provided purely for relaxation, stress relief, or general wellness—such as at a day spa or independent massage studio—is not covered under most Florida Blue medical plans. Some members may instead have access to discount programs for massage through wellness or holistic-care partnerships, which are separate from insurance coverage.3
Because Florida Blue administers multiple plan types (individual, group, state employee, Medicare Advantage, etc.), coverage can vary. You should always confirm your specific benefits through your contract or member portal.
Florida Blue’s Limitations on Massage Therapy
Florida Blue’s physical therapy medical coverage guideline includes massage under CPT 97124, but it also lists specific diagnosis codes for which massage is not covered, and states that all therapy is subject to medical-necessity review and contract limits.1
- Massage is typically covered only when billed as CPT 97124 under an approved physical therapy plan of care.
- Coverage is subject to medical-necessity review and documentation (treatment plan, progress notes, functional goals).
- There is a long list of ICD-10 diagnosis codes for which massage is not covered (for example, chronic pain syndromes, fibromyalgia, certain headaches, anxiety disorders).
- Plan-specific limits (for example, PT visit caps per year) may indirectly limit how many massage sessions are covered.
- Wellness or spa massage is not a covered medical benefit, even if discounted through wellness programs.
Florida Blue’s therapy guideline specifically identifies CPT 97124 as massage and then lists numerous ICD-10 diagnoses that are excluded for massage, indicating that coverage is tightly restricted to certain conditions and plans.1
When Is Massage Therapy Covered by Florida Blue?
Massage therapy may be covered when all of the following are true:
- The massage is part of a physical therapy (PT) treatment plan, not a stand-alone service.
- It is billed under an appropriate therapy CPT code (typically 97124 for massage) by a covered provider.
- A physician, advanced practice provider, or physical therapist has prescribed therapy and documented medical necessity (for certain plans, this is explicitly required).2
- The diagnosis and clinical documentation meet Florida Blue’s medical-necessity criteria for PT services.
Examples of situations where massage may be considered:
- Acute musculoskeletal injury being treated with PT (for example, a recent sprain or strain).
- Post-surgical rehabilitation where soft-tissue work is part of restoring function.
- Rehabilitation plans that clearly document impairment, functional goals, and response to treatment.
All services remain subject to plan limits, such as per-episode or annual PT visit maximums, and to ongoing documentation of clinical improvement.
Does Massage Therapy Require Pre-Authorization?
Often, yes — especially for extended or higher-cost therapy.
Florida Blue’s PT/OT medical coverage guideline notes that physical therapy services (including massage under CPT 97124) are subject to review, and many plans require pre-authorization or concurrent review after a certain number of visits.1,4
Your provider may need to submit some or all of the following:
- Diagnosis code(s) and clinical history
- A formal physical therapy evaluation
- A written plan of care with functional goals
- Periodic progress notes and outcome measures
Pre-authorization and utilization management requirements vary by product (commercial, state employee, Medicare Advantage), so members should confirm requirements using the Florida Blue Medical Policies and Coverage Guidelines and their plan documents.4
Massage Therapy That Is Not Covered
Massage therapy is typically not covered by Florida Blue when it is:
- Provided by an independent massage therapist, spa, or wellness center outside of a physical therapy setting.
- Performed for relaxation, stress reduction, or general wellness without a qualifying medical diagnosis.
- Billed under non-covered diagnosis codes listed in the Florida Blue PT medical coverage guideline (for example, certain headache syndromes, anxiety disorders, chronic pain syndromes, fibromyalgia, and other non-musculoskeletal conditions).1
- Provided after the acute or rehabilitative phase is complete (maintenance care).
- Offered as part of wellness discount programs rather than as a covered medical benefit.3
Members may still choose to use discounted massage services offered through Florida Blue’s holistic-care programs, but these are generally member-paid services, not insurance-covered benefits.
How to Check or Request Coverage for Massage Therapy
If you believe massage therapy might be covered under your Florida Blue plan, here are practical steps:
- Ask your physician or physical therapist whether massage could be part of a PT treatment plan for your condition.
- Have the PT practice verify your benefits and any pre-authorization requirements before you start treatment.
- Confirm whether massage will be billed as CPT 97124 under physical therapy benefits.
- Log in to your member portal or review your Evidence of Coverage to see any limits for physical therapy or massage therapy.
- Keep copies of prescriptions, authorizations, and EOBs for your records.
For the most accurate information, Florida Blue instructs members to refer to their contract or call the customer service number on their ID card.4
Does Florida Blue Require a Referral?
Referral rules depend on the type of Florida Blue plan you have:
- HMO and certain network plans may require a referral from your primary care provider for physical therapy services.
- PPO and some EPO plans may allow you to see an in-network physical therapist without a referral, but still require pre-authorization after a certain number of visits.
Referral and authorization rules are spelled out in your specific Evidence of Coverage or benefit booklet, and may differ for state employees, commercial group members, and Medicare Advantage members.1,4
Documentation Requirements
Florida Blue’s PT guideline emphasizes documentation when reviewing medical necessity for therapy services, including massage.1
- Physician history and physical
- Physical therapy evaluation and plan of care
- Progress notes and treatment summaries
- Objective measures (range of motion, strength, functional scales)
- Clear goals and reasons to continue or discontinue care
Incomplete documentation can lead to denial of therapy sessions, including those that involve massage (CPT 97124), even if the service was performed.
Reimbursement for Out-of-Network Massage Therapy
For PPO members, Florida Blue may reimburse some out-of-network physical therapy services, but this typically does not extend to independent massage therapists. Reimbursement for massage is generally limited to care billed as part of a covered PT plan by eligible providers.
Members should check:
- Whether their plan includes out-of-network PT benefits.
- How massage is billed (CPT 97124 under PT vs. a massage-only code from a non-PT provider).
- Out-of-network deductibles, coinsurance, and visit caps.
Where to Find More Information
You can review Florida Blue’s physical therapy medical coverage guideline (which includes massage CPT 97124) and other medical policies here:
Florida Blue Medical Policies (Medical Coverage Guidelines)1,4
For plan-specific details, log in to your member account at FloridaBlue.com or call the member services number on your ID card.
Frequently Asked Questions
Does Florida Blue cover massage at a spa or massage clinic?
No. Massage performed at a spa, massage studio, or wellness clinic is generally not covered as a medical benefit. Some plans may offer discounts on massage through wellness programs, but these are typically member-paid services.3
Is massage covered if it is part of physical therapy?
Possibly. Massage billed as CPT 97124 by a physical therapist, as part of a documented PT plan of care, may be covered when it meets Florida Blue’s medical-necessity criteria and diagnosis restrictions.1
Does Florida Blue limit the number of PT or massage visits?
Yes. Many plans include annual limits or per-episode limits for PT, which indirectly cap the number of covered massage sessions. Check your plan’s PT visit limits.
How can I confirm whether my specific plan covers massage?
Review your Evidence of Coverage, log in to your member portal, or call the number on your ID card. Because Florida Blue administers many different plans, benefits can vary significantly.
References
- Florida Blue. Physical Therapy (PT) and Occupational Therapy (OT) Medical Coverage Guideline, including CPT 97124 (massage) and ICD-10 diagnosis limitations for massage therapy.
- Florida Blue / State of Florida. State Employees’ PPO Plan Benefit Booklet (massage therapy prescription and medical-necessity requirements).
- Florida Blue. Follow the Blue – Holistic Care & Discounts (description of member discounts on massage therapy and other holistic services).
- Florida Blue. Medical & Pharmacy Policies and Guidelines – Medical Policies (Medical Coverage Guidelines).