Medical Massage Therapist

What is Medical Massage?

Medical Massage is result oriented and the treatment is specifically directed to resolve conditions that have been diagnosed and prescribed by a Physician. The therapist may use a variety of modalities or procedures during the treatment, but will focus the Medical Massage treatment only on the areas of the body related to the diagnosis and prescription. Medical Massage is generally billed in 15-minute segments using current procedural terminology and adhering to the usual and customary reimbursement fee schedule.

Why is a prescription necessary to perform Medical Massage?

In order for Massage Therapists to state that they are treating someone, they must first be able to legally determine what it is that they are actually treating.

Since it is beyond Massage Therapists' scope of practice to diagnose, they must work from a doctors prescription if they are claiming to treat a specific condition. Non-prescribed therapy may also be administered to address clients, where assessment shows soft-tissue imbalances.

Many in the field may think this is giving away their power to the physician, but nothing could be further from the truth. A physician can become our most powerful ally when we learn to work in a cooperative manner. I have worked well with Neurologists, Orthopedists, General Practitioners, Psychiatrists, Podiatrists, Oral Surgeons, Osteopaths, and Chiropractors.

Massage Therapists, Physicians and other health care professionals can work effectively together in the best interest of the patient/client.

Do I need a Medical Massage Certification in order to perform Medical Massage or bill Insurance Companies in the United States?

This question which continues to be asked concerns the issue of Medical Massage Certification, and how it relates to insurance reimbursement.

I will try to answer this in both a short and long answer: First the short answer, Massage therapy Certification in any sub specialty does not guarantee reimbursement from an insurance company.

Now for the long answer:

It has come to our attention that there are those who provide massage seminars who are advertising, and telling students, that it is necessary to attend their specific program and to achieve their certification in order to be able to bill and collect from insurance companies and also to perform Medical Massage within a physician's setting. This is patently untrue!
They are sending letters to Massage Therapists claiming that the "White House Commission on Complimentary Alternative Medicine has set the wheels in motion for incorporating certified Medical Massage therapists into the official health care system as of 2005".
This is also patently untrue. At this time there is only one state, Washington State, which has regulations providing for reimbursement of services for the Massage Therapists. Until recently, Florida had regulations in place, which provided for Massage Therapists to bill personal injury cases. This regulation was changed dramatically on May 4th, 2012, when Governor Richard Lynn Scott signed into law a bill that would prohibit the state's Massage Therapists and Acupuncturists from billing personal injury protection (PIP) insurance.

In order to perform Medical Massage, the Massage Therapist must always be licensed in his or her particular state, and have met the required educational standards in that particular state.

Some states will allow licensed therapists to bill for personal injuries, (car accidents etc.) if the service is deemed medically necessary by a referring physician. Some of these states will also allow for workers compensation reimbursement.

It is advised that all therapists get approval from any insurance carrier prior to beginning treatment.

In some unlicensed states, a person who practices massage therapy without a license, may be able to bill insurance for personal injury to a client, such as a car accident, but these are determined on an individual basis with the particular insurance company claims adjuster.

It is State Licensure and State regulations which determine the ability of a Massage Therapist or any provider of services to get reimbursement from insurance...