Does Medicare Cover Massage Therapy? Exploring Your Coverage Options

Does Medicare Cover Massage Therapy?

Massage therapy is an alternative treatment involving soft tissue manipulation to promote relaxation, wellness, and pain relief.

Many wonder if Medicare covers it for medical conditions.

This article explains massage therapy, its benefits, and Medicare coverage for it and other therapies.

Does Medicare Cover Massage Therapy?
Does Medicare Cover Massage Therapy? Discover massage therapy’s healing benefits, Medicare coverage eligibility for medical conditions.

What Is Massage Therapy?

Massage therapy is the application of pressure, movement, or vibration to the body’s muscles and soft tissues.

Therapists use hands, fingers, elbows, and tools for various techniques like Swedish, deep tissue, shiatsu, reflexology, and sports massage, each offering specific benefits based on individual needs and preferences.

Several potential advantages of massage therapy may include:

  • reducing stress and anxiety
  • improving blood circulation and lymphatic drainage
  • easing muscle tension and pain
  • enhancing flexibility and range of motion
  • promoting healing of injuries and wounds
  • boosting immune system function
  • improving mood and sleep quality

Insufficient evidence exists to support the effectiveness of massage therapy for various health conditions.

Further research is necessary to assess its safety, quality, and outcomes.

Does Medicare Cover Medical Care Outside The US?

Medicare does not cover medical care outside the US, including all 50 states, the District of Columbia, Puerto Rico, the US Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

Medicare may cover certain services outside the US in specific exceptional cases:

  • If you have a medical emergency in the US but the nearest hospital that can treat you is outside the US.
  • If you live in the US but a foreign hospital is closer to your home than a US hospital.
  • If you are traveling through Canada between Alaska and another state without unreasonable delay and you need emergency or non-emergency medical care.

Medicare may not fully cover all costs, leaving you responsible for deductibles, coinsurance, and copayments.

If you travel often or live abroad part of the year, consider getting supplemental insurance that covers foreign travel.

Certain Medigap plans offer emergency care coverage outside the US.

Check with your travel agent or insurance company for other travel health insurance options.

Is 97124 Covered By Medicare?

Code 97124 is a healthcare billing code for therapeutic procedures involving various body areas.

These techniques include effleurage, petrissage, tapotement, compression, vibration, friction, nerve strokes, and Swedish gymnastics.

Original Medicare does not cover code 97124 as it falls under alternative medicine.

However, some Medicare Advantage plans may cover it if prescribed by a doctor and performed by a licensed therapist as part of a medically necessary treatment plan.

For those with Medicare Advantage coverage for code 97124, following plan rules on prior authorization, referrals, network providers, cost-sharing, and submitting relevant documentation is necessary.

Does Tricare Prime Cover Massage Therapy?

Tricare Prime is a health insurance program for active duty and retired military members and their families.

It covers most medically necessary care, including preventive care, primary care, specialty care, hospitalization, prescription drugs, and some dental services.

Massage therapy is not covered unless part of a prescribed physical or occupational therapy program.

Beneficiaries may need prior authorization and could be subject to copayments or cost-shares, based on their plan and provider status.

What Is Code 97124?

Code 97124 is a billing code for therapeutic procedures involving one or more body areas.

It includes techniques like effleurage, kneading, and percussion.

Original Medicare doesn’t cover it as it falls under alternative medicine.

However, some Medicare Advantage plans may cover it if prescribed by a doctor and performed by a licensed therapist.

If covered, follow plan rules for authorization, referrals, network providers, and cost-sharing, and provide necessary documentation.

Conclusion

Massage therapy is an alternative treatment that relaxes the body and eases pain.

While Original Medicare doesn’t cover it, some Medicare Advantage plans might cover it with certain requirements.

Medical care outside the US is typically not covered, but supplemental insurance can assist.

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