Does Medicare Pay for Massage Therapy?

Medicare is a federal health insurance program designed to provide coverage for individuals generally aged 65 or older, younger people with certain disabilities, and people with End-Stage Renal Disease. This program assists with various healthcare service costs, including hospital stays, medical appointments, and certain medical supplies. Medicare aims to help beneficiaries manage their health needs by covering a range of medically necessary treatments and preventive services.

Medicare’s Stance on Massage Therapy

Original Medicare (Parts A and B) generally does not cover massage therapy as a standalone service. It is considered an alternative or complementary treatment, not a direct medical service, and is not deemed medically necessary for direct reimbursement. Specific billing codes for primary massage therapy services are generally absent.

Individuals seeking massage therapy solely for relaxation, general pain relief, or wellness are responsible for the entire cost. Medicare does not categorize these services as essential medical care for direct payment. While some Medicare Advantage (Part C) plans may offer supplemental benefits that include massage therapy, coverage varies significantly by plan and region.

Covered Therapeutic Services

While standalone massage therapy is not typically covered, Medicare Part B does provide coverage for several therapeutic services that may incorporate manual techniques.

Physical therapy (PT) helps restore function, improve mobility, and reduce pain after injury, illness, or surgery. Manual therapy, involving hands-on techniques like joint mobilization and myofascial release, can be a component of a comprehensive physical therapy plan when performed by a licensed physical therapist and deemed medically necessary.

Occupational therapy (OT) helps individuals regain skills for daily living and working. Occupational therapists may utilize manual techniques as part of a broader treatment plan to improve a patient’s ability to perform everyday tasks. This coverage applies when services are medically necessary and part of a prescribed plan of care.

Medicare Part B also covers manual manipulation of the spine by a chiropractor to correct a vertebral subluxation. This specific chiropractic service is covered when medically necessary to treat a diagnosed condition. However, other services offered by chiropractors, such as X-rays or massage therapy, are generally not covered by Original Medicare.

Requirements for Coverage

For Medicare to cover therapeutic services like physical therapy, occupational therapy, or chiropractic care, services must be medically necessary. This means the treatment is reasonable and essential for diagnosing or treating an illness or injury, aligning with accepted medical practice standards.

A physician or other qualified healthcare provider must prescribe or refer the patient for these services. Services must be performed by a Medicare-approved, licensed professional, such as a physical therapist, occupational therapist, or chiropractor. Treatments should also be part of a written plan of care, reviewed and signed by a physician, outlining the goals and expected outcomes of the therapy.

While Medicare no longer has a hard cap on the amount it pays for outpatient therapy services, providers must document the medical necessity of care when costs exceed certain thresholds. For 2025, if the combined costs for physical and speech-language pathology services, or occupational therapy services alone, exceed approximately $2,410, additional justification is required to confirm the ongoing medical necessity of the treatment. This documentation ensures that Medicare continues to cover necessary care without imposing arbitrary limits.

Understanding Costs

When Medicare covers therapeutic services, beneficiaries typically incur some out-of-pocket costs.

For services covered under Medicare Part B, such as physical therapy, occupational therapy, and chiropractic spinal manipulation, the annual Part B deductible must first be met. For 2025, this deductible is $257.

After the deductible has been satisfied, Medicare generally pays 80% of the Medicare-approved amount for these services. The beneficiary is then responsible for the remaining 20% coinsurance. This coinsurance applies to each covered session or service.

If an individual opts for standalone massage therapy not integrated into a Medicare-covered treatment plan, the cost is 100% out-of-pocket. Medicare does not provide reimbursement for these services.