Does Insurance Cover Massage?

Insurance coverage for massage therapy varies significantly across providers. Some insurers recognize massage as a medically necessary service for pain, injury recovery, and certain chronic conditions, while others treat it as wellness or self-care, which is rarely covered. Understanding how your health plan views massage therapy can help you avoid unexpected costs and make more informed choices about your care.

Understanding Massage Therapy in a Medical Context

Massage therapy is most commonly associated with relaxation and stress relief, but it also plays a role in medical and rehabilitative care. Therapeutic massage can help reduce muscle tension, improve circulation, support recovery from injuries, and manage conditions such as chronic back or neck pain, headaches, and postural strain.

When massage therapy is part of a treatment plan ordered by a licensed provider (such as a physician, chiropractor, or physical therapist) and directed at a specific diagnosis, it is more likely to qualify as medically necessary. When it is provided purely for general wellness, stress reduction, or spa-like services, insurance carriers typically will not cover it.

Does Health Insurance Cover Massage Therapy?

Coverage for massage therapy depends on the details of your health insurance plan. While some carriers include massage as part of rehabilitative or physical medicine benefits, many limit coverage to very specific situations. These usually include:

A clearly defined medical diagnosis (for example, low back pain or post-surgical recovery)
A physician’s prescription or referral
Treatment delivered by a licensed provider recognized by the plan (LMT, PT, DC, etc.)
Documentation showing functional improvement over time

Wellness-oriented massage, maintenance care, and general relaxation sessions are almost never considered medically necessary and are usually not covered. Many massage therapists therefore choose not to participate in insurance networks and instead offer straightforward self-pay fees.

Find Massage Therapy Coverage Policies by Insurance Carrier

Types of Insurance Plans Covering Massage Therapy

HMO (Health Maintenance Organization): Often requires that massage be provided by an in-network provider and tied to a physician-ordered treatment plan. A referral from your primary care physician is commonly required.
PPO (Preferred Provider Organization): Offers more flexibility to see out-of-network providers, but coverage is still usually limited to medically necessary massage, and out-of-pocket costs may be higher.

In both HMO and PPO plans, massage is far more likely to be covered when it is part of a rehabilitative or pain-management program rather than a stand-alone wellness service.

In-Network vs. Out-of-Network Massage Therapists

Most health plans maintain a network of preferred providers. When massage therapy is covered, insurers usually require you to see an in-network provider or receive services in a clinic that is already credentialed with the plan. Using an in-network provider can significantly reduce your costs.

Out-of-network therapists may still be covered under some PPO plans, but reimbursement is often lower, and you may need to submit your own receipts and documentation. Many massage therapists remain out of network or fully self-pay because the administrative burden of dealing with insurance is high compared to the reimbursement they receive.

Medical Necessity of Massage Therapy Visits

Insurers typically cover massage therapy only when it is considered medically necessary. That means:

There is a specific diagnosis and documented symptoms.
Treatment goals focus on functional improvement (for example, improved mobility or reduced pain that allows daily activities).
Progress notes show that symptoms and function are changing over time.

Relaxation massage, general wellness sessions, and ongoing maintenance care are usually not considered medically necessary. These services are commonly denied upon review, even if a plan technically lists massage therapy as a covered benefit.

Massage Therapy Visit Limits

Even when massage therapy is covered, most plans place limits on the number of sessions allowed within a certain period (for example, 6–20 visits per year or per condition). These limits are often enforced through medical necessity guidelines and periodic reviews.

Having a plan that lists a certain number of visits does not guarantee all of them will be approved. If your insurer decides that additional massage sessions no longer meet their medical necessity criteria, future claims may be denied even if you have not reached the stated visit cap.

Pre-Authorization of Massage Therapy

Many insurance plans now require pre-authorization before massage therapy will be covered. This process often involves submitting documentation of the diagnosis, treatment goals, and planned frequency of visits before you start care.

Pre-authorization is frequently managed by third-party companies that administer physical medicine or complementary care benefits on behalf of the insurer. These companies may apply additional rules, such as stricter visit limits or outcome requirements, which can delay treatment or result in denials if the process is not followed precisely.

Because requirements differ between carriers, it is important to confirm pre-authorization steps with both your insurance plan and your massage provider’s office.

Deductibles and Co-pays

Even if your massage therapy visits are covered, you may still be responsible for deductibles, co-pays, or coinsurance. These out-of-pocket costs depend on your plan design and must usually be collected at the time of service.

Routinely waiving co-pays or deductibles for insured massage therapy is considered fraud and can lead to serious consequences for providers. To avoid surprises, it is important to understand your plan’s cost-sharing rules before starting care.

Paying for Massage Therapy Out of Pocket May Save You Money

Because of the strict rules around medical necessity, documentation, and pre-authorization, many massage therapists choose to remain out-of-network or entirely separate from insurance. Instead, they offer clear, self-pay rates that allow them to focus on patient care rather than paperwork.

In some cases, paying directly for massage therapy can be more affordable and flexible than using insurance. Without carrier-imposed treatment plans, you and your therapist can decide how often to schedule visits and which techniques to use based on your goals and response to care, rather than a third-party guideline.

Each massage therapist sets their own fees and policies, so it is important to contact offices directly to learn about pricing, packages, and any options for using health savings accounts (HSAs) or flexible spending accounts (FSAs) for eligible services.

How to Verify Your Massage Therapy Coverage

To find out whether your plan covers massage therapy, follow these steps:

Call your insurance provider: Use the customer service number on the back of your insurance card and ask specifically about massage therapy benefits.
Ask about requirements: Confirm whether you need a prescription, referral, or pre-authorization and whether coverage is tied to a diagnosis or physical therapy plan.
Clarify visit limits and costs: Ask how many visits are allowed, what your co-pay or coinsurance will be, and whether the deductible applies.
Confirm provider status: Verify whether your massage therapist is in-network and how claims will be submitted.

Insurances That Cover Massage Therapy

Click the insurance company below to learn more about how each carrier handles massage therapy benefits.

Aetna

Aetna acknowledges the benefits of massage therapy and may offer discounts or limited coverage through certain plans and wellness programs. However, coverage is often restricted to medically necessary care that is part of a broader treatment plan, such as physical therapy or rehabilitation, and must meet specific criteria.