Does Independance Health Group Cover Massage Therapy?

Updated [November 14, 2025]

Reviewed by: Dr. Donald L. Aivalotis, II

This guide explains whether Independence Health Group (Independence Blue Cross) covers massage therapy, including medical necessity rules, coverage limitations, provider requirements, and pre-authorization criteria.

Is Massage Therapy Covered by Independence Blue Cross?

Occasionally — but only when massage is provided as part of a medically necessary, licensed physical or rehabilitative therapy plan, not as stand-alone wellness or spa massage.

According to Independence Blue Cross policy documents, massage therapy (CPT 97124) is not listed as a separate covered benefit under many individual or employer-group plans. However, when massage is included under a rehabilitation or physical therapy plan of care, and delivered by a credentialed physical therapist or other approved provider, coverage may be considered—subject to documented functional goals and treatment outcomes.¹

For example: If a member has a work-related left shoulder strain, the physician refers them to physical therapy, and the physical therapist includes soft-tissue massage techniques to restore range of motion and reduce spasm, then the service may be covered under therapy benefits—provided it meets criteria and is billed correctly under CPT 97124 (or the applicable therapy/modal code) by a participating provider.

If massage is offered as a separate service in a massage-only setting (spa, salon, LMT-owned clinic) without integration into a covered therapy plan, Independence Blue Cross generally does not treat it as a covered medical benefit.

Independence Blue Cross’s Limitations on Massage Therapy

Massage provided without a formal plan of care or diagnosis is not covered.
Massage performed by a licensed massage therapist (LMT) outside a therapy plan is excluded in many contracts.¹
Massage for relaxation, general wellness, or maintenance care is not reimbursed.
Employer-group plans may exclude massage entirely or require that it be billed under physical therapy benefits to be eligible.

Independence Blue Cross policy documentation repeatedly lists massage therapy as a non-covered service unless manually included under therapy. For example, one benefits booklet states: “Massage therapy including effleurage, petrissage, tapotement is not covered unless part of a physical therapy plan.”²

When Is Massage Therapy Covered?

Massage therapy may be covered when:

It is part of a physician- or physical therapist-directed rehabilitative plan of care.
The service is billed under a recognized therapy code (for example, CPT 97124) by a qualified provider (e.g., PT) in-network.
It is intended to restore function, reduce impairment, and reach measurable goals—not simply reduce stress or provide comfort.
Documentation supports medical necessity, such as diagnosis, functional deficits, frequency/duration plan, and progress notes with improvement.

Examples might include: acute sports injuries, post-surgical rehabilitation, or re-entry to work after musculoskeletal trauma—all managed within a therapy plan rather than as stand-alone massage sessions.

Does Massage Therapy Require Pre-Authorization?

Sometimes—but it depends on the contract.

Independence Blue Cross’s physical therapy benefits guide indicates that services such as soft-tissue modalities, manual therapy, and massage may require prior authorization when therapy exceeds a certain number of visits or when billed to out-of-network providers. Providers are encouraged to verify authorizations before initiating treatment.³

Members should call the number on their ID card or check their online member portal for “rehabilitative therapy” benefits and see whether massage codes are included in the treatment plan prior to service.

Massage Therapy That Is Not Covered

Independence Blue Cross does not cover massage therapy when it is:

Provided in a spa or wellness center setting outside of a therapy plan.
Performed solely for relaxation, stress reduction, or lifestyle enhancement.
Delivered by a massage therapist or other non-therapy provider without a PT/rehab referral.
Part of ongoing maintenance care unrelated to a new injury, illness, or rehabilitation plan.

Even when a therapy plan includes massage techniques, if documentation stops showing objective functional improvement, it may become non-covered under the plan’s rehabilitative benefit rules.

How to Get Pre-Authorization for Massage Therapy

Here’s how to check if your plan allows massage therapy under Independence Blue Cross:

Review your Summary of Benefits & Coverage (SBC) or Employer-Group plan booklet for “rehabilitative and habilitative services” or “physical therapy/occupational therapy.”
Ask your physician or physical therapist to document the plan of care and identify massage codes like CPT 97124 if they will be used.
Your provider should contact Independence Blue Cross provider services to check whether the planned massage/soft-tissue services will be reimbursed under the therapy benefit.
Confirm any prior authorization requirements or visit-limit caps before starting treatment.

If you get billed for a massage service and you were not told whether it was part of a covered physical therapy benefit, ask for an explanation of benefits (EOB) showing whether therapy benefits were applied or the claim was denied as “non-covered massage.”

Does Independence Require a Referral?

Referral requirements depend on your specific Independence Blue Cross plan:

HMO plans: A primary care physician (PCP) referral may be required for physical therapy, which includes any massage that is part of the therapy plan.
PPO/EPO plans: Many allow you to seek in-network physical therapy without referral, but therapy must still meet medical-necessity and prior-authorization rules.

Check your plan’s member portal or call Member Services to confirm referral rules for your rehab benefit.

Documentation Requirements

Independence Blue Cross emphasizes the following documentation standards for rehabilitative services that may include massage techniques:^2,3

Initial evaluation with diagnosis, severity, and functional impairment.
Treatment plan listing therapeutic modalities (including massage code if used), frequency, and duration.
Progress notes showing objective improvement (range of motion, strength, return to function).
Time-based codes must be correctly entered, and modifiers applied when multiple distinct body regions are treated.

Without meeting these documentation standards, claims for massage (CPT 97124) or soft-tissue modalities may be denied or re-coded as non-covered therapy services.

Reimbursement for Out-of-Network Massage Therapy

If you have an out-of-network provider and wish to seek reimbursement under Independence Blue Cross, the following generally apply:

Out-of-network benefits may exist for physical therapy, but they often exclude massage performed outside of therapy. To maximize reimbursement:

Ensure the provider is credentialed and the service is billed under physical therapy benefit codes (not massage-only codes).
Verify whether your plan covers out-of-network physical therapy and whether visit-limits, co-insurance or deductibles differ.
Keep documentation that therapy included massage techniques and had measurable functional goals.

Because out-of-network massage alone is rarely honored under Independence Blue Cross, many members end up paying out-of-pocket for spa or complimentary massage unless it is clearly integrated into a therapy plan.

Where to Find More Information

You can begin your research here:
Independence Blue Cross Member & Plan Documents – for benefit booklets, “What’s Not Covered” lists and therapy-benefit details.¹

If you are a provider, use the provider portal:
Independence Blue Cross Medical Policy Search – to check coverage rules, CPT codes, and therapy-policy bulletins.³

Frequently Asked Questions

Does Independence cover massage therapy for stress or wellness?
No. Massage for stress relief, relaxation, or wellness is generally excluded unless part of a covered therapy plan with documentation.

Can a licensed massage therapist bill Independence directly for CPT 97124?
In most cases, no. Unless the code is billed under a licensed physical therapist’s therapy benefit and is part of a rehabilitative plan, it won’t be reimbursed.

How many massage or soft-tissue sessions will my plan cover?
Coverage depends on your plan’s physical therapy visit limits and the therapy plan of care. There is no universal “massage session max.” Confirm with your plan.

What should I do if my claim for massage therapy was denied?
Request a detailed Explanation of Benefits (EOB), check whether the code was billed under therapy vs. massage, ask if prior authorization was required, and submit an appeal with documentation of functional goals and provider credentials.

References

Independence Blue Cross. What’s Not Covered – Massage Therapy (Individual & Employer Plan Booklets).
Independence Blue Cross. Rehabilitative Therapy Benefit Guidelines – Physical & Occupational Therapy.
Independence Blue Cross. Medical Policy Search – Rehabilitation Services including CPT 97124, manual therapy, soft-tissue mobilization.