You always need a prescription for medical massage, even if your plan says you can self-refer. Here’s why. It’s not in my scope of practice as a massage therapist to diagnose, yet the insurance billing forms require a diagnosis code before they will pay. If I were to just make up a diagnosis code and put it on the form, I could probably get paid, but I’d be breaking the law and putting my cherished massage license at risk. So I always need a prescription from your doctor before commencing medical massage treatments. Also, virtually all insurance policies now require that massage be “medically necessary,” which is another judgment that is outside of my scope of practice, and they almost all require a “formal, written treatment plan” from your doctor. The quickest way to take care of all of these requirements is to have your doctor fill out my “Massage Therapy Referral / Prescription / Treatment Plan” form.
Unfortunately, the different arms of the typical insurance company don’t do a good job of communicating with each other and/or they don’t understand the laws regarding the scope of practice for massage therapists, so you are very likely to get a customer service rep on the phone insisting that you don’t need a prescription or referral to get them to pay for your massage. Sorry, but that’s just not correct.