Medical Massage…How New Health Care Reform Laws Enforce Insurance Coverage

Medical Massage is the therapeutic application of specific massage therapy protocols for particular conditions evaluated and diagnosed by a physician. Between the years of 1998 and 1999, the American Medical Massage Association and the United States Medical Massage Association were established to bridge the gap between the standard medical community and professional massage therapists.

Currently, more skilled massage therapists are raising their credentials by increasing their education levels (approximately 42 hours) to acquire a Medical Massage National Certification.  A licensed massage therapist can bill insurance for a massage, as long as they have a doctor’s referral and can show some improvement in a patient’s condition as a result of massage therapy services.

Although any therapist can bill insurance for massage therapy services; therapist with a National Certification in Medical Massage have much greater chances of getting paid by major insurance carriers.

Medical massage is deemed necessary for patients with the following conditions:

• Sciatica
• Carpal tunnel syndrome
• Fibromyalgia
• Rotator cuff injuries
• Piriformis syndrome
• Muscle cramps
• TMJ
• Edema (swelling)
• Bodily traumas due to injuries such as falls and automobile accidents
• Thoracic Outlet Syndrome (numbness and tingling in the arms and hands)
• Plantar fasciitis (severe pain in the foot)
• Pain associated with bulged or injured spinal disks
• Range of motion problems
• Back and neck pain
• Pain associated with restricted fascia
• Migraines and headaches
• Restless Legs Syndrome
• Work and Auto Injuries
• Sports injuries
• Repetitive injures like tennis elbow and Golfer’s elbow
• Pain associate with postural imbalances
• Constipation
• Pain associated with pregnancy

According to the American Academy of Family Physicians, “The recently enacted health care reform legislation (which calls for major insurance carriers to eliminate financial barriers for many preventive services) will create a greater demand for these services and give physicians a better opportunity to provide preventive care.”

It is stated in the Patient Protection and Affordable Care Act at http://www.thomas.gov/, that new health plans, established on or after September 23, 2010, will be required to cover and eliminate deductibles, co-pay, and coinsurance amount on preventative services.

However, these preventative services must be strongly supported by scientific evidence, and recommended by health agencies like the US Department of Health and Human Services. In addition, Medicaid and Medicare programs are scheduled to adopt the same previsions as of January 1, 2011.