Health Insurance For Massage Therapy

Many Health Insurance Plans now cover massage and manual therapy as part of a treatment protocol. Depending on your coverage, you may be eligible for massage therapy benefits. Our clinic partners with several in-network insurance providers and also offers options for out-of-network coverage, ensuring you can find a plan that fits your needs.

Pricing depends on your health insurance plan. Patients are responsible for any copays, coinsurance, and the deductible when applicable.

In-Network

With in-network coverage, our providers are contracted with your insurance company to deliver massage therapy services under your in-network benefits. We are In-Network with:

  • Providence

  • Blue Cross Blue Shield

  • MODA

  • First Choice

Out-of-Network

With out-of-network benefits, we don't have a direct contract with your insurance company. While we do not bill your insurance directly, we can provide a superbill for submission to the insurance carrier . We are out-of-network with:

  • PacificSource

  • United

  • Aetna

  • Cigna

  • Kaiser

Motor Vehicle Accident (MVA)

For Motor Vehicle Accident (MVA) treatment, we can accept insurance through the car insurance provider and handle claims via Personal Injury Protection (PIP). MVA cases are managed differently from traditional health insurance coverage. For more details, please visit our MVA page by clicking below.

Not Covered

Unfortunately, we do not accept the following plans for massage therapy:

  • Oregon Health Plan (OHP)

  • Medicare

  • Marketplace Plans

  • Medicaid

  • Workers Compensation

How can i find out if massage therapy is covered under my benefits?

Step 1: Contact your insurance carrier to confirm if massage therapy is included in your plan. This will provide you with immediate answers about your coverage and any specific requirements, such as deductibles or pre-authorizations.

Step 2: Allow us to verify your benefits for you. We’ll help you understand your coverage options and answer any questions.

We’re here to assist you every step of the way!

Health Insurance FAQS

  • Most plans renew at the beginning of every calendar year and some plans renew in the summer or fall. When insurance plans reset your deductible will start over. Additionally, copays and benefits may change from year to year, so it’s important to review your plan details.

  • Yes, we accept HSA and FSA cards for both in-network and out-of-network plans.

  • Massage therapy services are billed at $45 per unit. For in-network plans, we adhere to a contracted rate, which is often discounted from our standard billed rate.

  • No, if you have an open claim with workers' compensation for a work-related injury, we are unable to bill your health insurance plan until the workers' compensation claim is closed. We do not accept workers' compensation cases.

  • Patients are responsible for any balances and fees accrued for massage therapy services rendered. Please note that verification of benefits by Canopy Clinic does not guarantee payment. If your account has an outstanding balance, we will notify you and send an invoice. If there’s uncertainty regarding your insurance coverage, we can proceed with charging for the first treatment and will notify you once we receive further information from your insurance company about your plan.

  • No, if you have an open claim through PIP, we are required to bill the car insurance company. Once the claim is closed, we can then inquire about billing your health insurance.

  • Yes, we have a 24-hour cancellation policy. Cancellations made with less than 24 hours' notice incur a $115 fee. This allows us to better serve clients waiting for appointments. Thank you for understanding.

  • No, a prescription is not typically required unless your health insurance plan specifically requests one. Some plans may have this requirement, so please verify with your insurance provider.

  • A superbill is an itemized receipt we provide for services you’ve paid for, which you can submit to your insurance for potential reimbursement if your plan includes out-of-network coverage. You’ll handle the submission process directly with your insurance carrier, and reimbursement amounts depend on your specific policy.

Understanding Insurance Coverage for Massage Therapy

Massage therapy is increasingly being covered under health insurance plans to treat pain and support rehabilitation from musculoskeletal imbalances. However, coverage depends on your specific health plan, as insurance companies require a determination of medical necessity for massage therapy to be covered. Insurance may categorize massage therapy as either:

  • Medically Necessary

  • Non-Medically Necessary

Treatments classified as non-medically necessary - such as those aimed at relieving stress or promoting relaxation - are typically not covered by insurance providers. For instance, individuals seeking massage for anxiety will not be eligible for coverage.

In cases where musculoskeletal pain and/or rehabilitation are deemed medically necessary, insurance companies may provide varying levels of coverage. Rehabilitative massage therapy treatments are typically aimed at restoring function to a the musculoskeletal system. However, insurance providers have different criteria to determine if massage therapy qualifies as 'medically necessary.' These criteria may include one or more of the following:

  • Pain: The patient must be experiencing pain..

  • Lifestyle Disruption: The patient’s pain disrupts daily activities.

  • Mobility: Muscular dysfunction is impairing mobility and causing discomfort.

  • Onset of Pain: There is an identifiable onset of pain, or timeframe, due to injury or musculoskeletal dysfunction.

Understanding these guidelines can help you navigate your insurance benefits and ensure that you receive the appropriate coverage for your therapeutic needs.