How to get medically cleared.
A guide to referrals and insurance verification for medical massage.
Understanding “In Lieu of Services”.
Some plans offer alternative therapies as a substitute for traditional treatment.
Example: Carolina Complete Health offers cost-effective substitutions for services covered by NC Medicaid, including massage therapy in lieu of opioid pain management. You are not required to use in-lieu-of services; the plan will connect you to them.
How to use your benefits.
Four things to do first.
Steps for medical clearance.
Six steps from first call to first session.
Contact your insurance company
Ask about medical massage benefits, prior authorization, referrals and out-of-pocket costs. Write down the representative's name and reference number.
Speak with your medical provider
Explain your symptoms and ask whether medical massage would be appropriate.
Request documentation
A referral or prescription with diagnosis, frequency and length of care.
Choose a licensed provider
Look for clinics that work with referrals and keep clinical documentation.
Submit your referral to the clinic
We help with benefit verification and next steps.
If insurance doesn't cover it
Cash medical rates, packages, HSA/FSA funds and superbills for reimbursement.
Frequently asked questions.
Billing, HSA/FSA and referrals.
Do you bill my insurance directly?
With the exception of VA Community Care (where we are an authorized provider), we are typically an out-of-network provider. We can provide you with a detailed "superbill" that you can submit directly to your insurance company for potential reimbursement.
Can I use my HSA or FSA?
Yes. We accept all major Health Savings Account (HSA) and Flexible Spending Account (FSA) cards. Medical massage is generally an eligible expense, especially with a letter of medical necessity from your doctor.
What if I don't have a referral?
You can still book a session. Referrals are primarily needed if you are seeking insurance reimbursement or using certain HSA/FSA funds. You are always welcome to pay out-of-pocket for any of our services.
Ready to schedule?
Whether you are using insurance, HSA/FSA, or paying out-of-pocket, we are ready to support your recovery.
Coverage is determined by your carrier. This guide is educational and does not guarantee coverage.
