Can You Use Your FSA for Massage Therapy?

Flexible Spending Accounts (FSAs) are a benefit employers often offer, allowing employees to pay for certain out-of-pocket healthcare expenses with pre-tax dollars. This tax advantage can lead to significant savings on eligible costs. A common feature of FSAs is the “use-it-or-lose-it” rule, which typically requires funds to be spent by the end of the plan year, though employers may offer options like a grace period or a limited carryover. Individuals frequently wonder which specific expenses qualify for reimbursement through these accounts.

Understanding FSA Basics

A Flexible Spending Account operates under specific Internal Revenue Service (IRS) guidelines regarding eligible expenses. To qualify, an expense must primarily be for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body. This means that the expense must address a medical condition rather than being for general health or wellness. For instance, items or services intended for general health, wellness, or cosmetic purposes are typically not covered unless they directly treat a specific medical condition.

Many expenses require medical necessity to be considered eligible. This principle ensures that FSA funds are used for legitimate healthcare needs as defined by the IRS. The money contributed to an FSA is deducted from an employee’s paycheck before taxes, reducing their taxable income. While employers can contribute to an FSA, they are not obligated to do so.

Massage Therapy and FSA Eligibility

Massage therapy is generally not eligible for FSA reimbursement if its purpose is general relaxation, stress relief, or overall wellness. However, it can be covered if it is medically necessary to treat a specific diagnosed medical condition. The IRS classifies therapeutic massage as a qualified medical expense when used to address a legitimate health issue.

Examples of conditions where therapeutic massage might be considered medically necessary include chronic pain, such as back or neck pain, carpal tunnel syndrome, and certain musculoskeletal disorders. It can also be eligible for injury recovery, stress-related conditions like anxiety or hypertension, and neurological conditions such as sciatica. The primary purpose of the massage must be treatment of a specific ailment, not simply relaxation. This medical necessity implies that a qualified healthcare professional has prescribed or recommended it as part of a defined treatment plan.

Required Documentation for Reimbursement

To substantiate a claim for medically necessary massage therapy, specific documentation is required. A Letter of Medical Necessity (LMN) from a physician or other qualified healthcare provider is often essential for services that are not automatically eligible. This letter must explain why the massage therapy is recommended to treat or mitigate a specific health condition. It typically includes details such as the medical diagnosis, how massage therapy treats that condition, and the duration or frequency of the prescribed treatment.

In addition to an LMN, a prescription or referral specifically for massage therapy from a doctor is necessary. This prescription should include relevant diagnosis codes that link the massage to a specific medical condition. Itemized receipts from the massage therapist or facility are also required. These receipts must clearly show the date of service, a detailed description of the service (e.g., “therapeutic massage” rather than “relaxation massage”), and the amount paid. Without this specific and comprehensive documentation, the expense will likely be denied reimbursement.

The Reimbursement Process

Once all necessary documentation has been gathered, the next step is to submit the claim for reimbursement. Most FSA administrators offer multiple submission methods, such as online portals, mobile applications, or mail. When submitting online, individuals typically input information like the date of service, provider name, and the amount of the expense. Scanned copies or images of the supporting documentation must be uploaded or attached.

After submission, the FSA administrator processes the claim. The processing time for FSA reimbursements typically ranges from three to five business days. If approved, reimbursement is usually issued shortly thereafter, with direct deposit being the quickest and most secure method. Funds are often received in the bank account within one to three business days after approval. Alternatively, some administrators may issue a paper check, which can take five to ten business days to arrive by mail.