What is Medical
Massage is result oriented and the treatment is
specifically directed to resolve conditions that have been diagnosed and
The therapist may use a variety of modalities or procedures during the
treatment, but will focus the Medical Massage treatment only on the areas of the body
related to the diagnosis and prescription. Medical Massage is generally billed in
15-minute segments using current procedural terminology and adhering to
the usual and customary reimbursement fee schedule.
Why is a
prescription necessary to perform Medical Massage?
In order for Massage Therapists to state that they are treating someone, they must
first be able to legally determine what it is that they are actually
Since it is beyond Massage
Therapists' scope of practice to diagnose, they must work from a
doctor’s prescription if they are claiming to treat a specific
condition. Non-prescribed therapy may also be administered to address
clients, where assessment shows soft-tissue imbalances.
Many in the field may think this
is giving away their power to the physician, but nothing could be
further from the truth. A physician can become our most powerful ally
when we learn to work in a cooperative manner. I have worked well with
Neurologists, Orthopedists, General Practitioners, Psychiatrists,
Podiatrists, Oral Surgeons, Osteopaths, and Chiropractors.
Massage Therapists, Physicians and other health
care professionals can work effectively together in the best interest of
Do I need a Medical
Massage Certification in order to perform Medical Massage or bill
Insurance Companies in the United States?
This question which continues to be asked
concerns the issue of Medical Massage Certification, and how it
relates to insurance reimbursement.
I will try to answer this in both a short and
First the short answer, Massage therapy
Certification in any sub specialty does not guarantee
reimbursement from an insurance company.
Now for the long answer:
It has come to our attention that there are
those who provide massage seminars who are advertising, and telling
students, that it is necessary to attend their specific program and to
achieve their certification in order to be able to bill and collect
from insurance companies and also to perform Medical Massage within a
physician's setting. This is patently
They are sending letters to
Massage Therapists claiming that the "White House Commission on
Complimentary Alternative Medicine has set the wheels in motion for
incorporating certified Medical Massage therapists into the official
health care system as of 2005".
This is also patently
At this time there is only one state, Washington
State, which has regulations providing for
reimbursement of services for the Massage Therapists. Until recently,
Florida had regulations in place, which provided for Massage
Therapists to bill personal injury cases. This regulation was
changed dramatically on May 4th, 2012, when Governor Richard Lynn
Scott signed into law a bill that would prohibit the state's Massage
Therapists and Acupuncturists from billing personal injury
protection (PIP) insurance.
In order to perform Medical Massage, the Massage
Therapist must always be licensed in his or her particular state,
and have met the required educational standards in
that particular state.
Some states will allow licensed therapists to
bill for personal injuries, (car accidents etc.) if the service is
deemed medically necessary by a referring physician.
Some of these states will also allow for workers
It is advised that all therapists get
approval from any insurance carrier prior to beginning treatment.
In some unlicensed states, a person who practices
massage therapy without a license, may be able to bill insurance
for personal injury to a client , such as a car accident, but
these are determined on an individual basis with the particular
insurance company claims adjuster.
It is State Licensure and State regulations
which determine the ability of a Massage Therapist or any provider of
services to get reimbursement from insurance companies, not
certifications by anyone or any organization.
Please do not be misled into believing you need
to join any organization , or get any particular certification so that
you can bill insurance companies for your services.
IWe do support your being a member of associations
(for example: AMTA,
TAMT, and other legitimate state or
national organizations), which work for the betterment of our
Getting certified in particular specialties
should certainly improve your skills and hopefully your ability
to create a more successful practice, whether you choose to
utilize insurance billing, work within a physician's setting or
Be aware of private organizations and private
associations, which mislead you into believing that you will be left
out of the Medical Massage field if you do not take their particular
certification or join their particular organization.
is also patently untrue!
What our industry needs in order to be accepted
by the insurance industry on a national basis, is a national standard
All states will have to come together and agree
on a minimum standard curriculum .
This is the same as the Physical
Therapists, Chiropractors ,Doctors etc. have had to do.
This is the only way an insurance company can
know that when they receive a bill for payment from someone for
massage therapy, that person has achieved a standard of training which
is accepted by all .
What Types of
Massage Therapy are considered Medical Massage?
all forms of Massage Therapy can be therapeutic when applied by a
skillful and knowledgeable
Therapist; therefore Medical Massage is not limited to any
particular specific technique.
several approaches in our Medical Massage Practitioner training,
including, but not limited to, Muscle Testing, Neuromuscular Therapy,
Myofascial Release, Positional Release, Trigger Point Therapy, and
Rehabilitative Stretching Procedures.
is common for some to play down the effects of so called Relaxation
Massage and to even call it “Fluff “but as we learn more about the stress
response and it’s role in creating disease, we see a definite need for
this type of service when necessary. Cardiologists and Psychiatrists are
excellent referral sources.
to combine the intuitive and scientifically proven principles defines
the art and science of Medical Massage Therapy.
What are the benefits of Medical
The following lists many of
the benefits of Medical Massage
- Releases tight and sore
muscles which can cause Ischemia (Ischemia:
lack of blood supply to soft tissues, which causes hypersensitivity
to the touch and allows for further injury to the tissues)
relieve nerve compression or entrapment. (Pressure
on a nerve by soft tissue, cartilage or bone, which can contribute
to muscle atrophy, referred pain, paresthesia, and conditions such
as pseudo sciatica, piriformis syndrome, pseudo angina, and others.)
Myofascial Trigger Points (Trigger
Points: Areas of high neurological activity, which refer pain to
other parts of the body. Research has shown, trigger points may be
responsible for as much as 74% of everyday pain.)
Pain And Inflammation:
can restore suppleness and strength to your muscles, improving their overall
function. It's the ideal treatment for releasing tension or muscles
in spasm and helps to release toxins such as lactic acid (produced
by muscle tissue during exercise).
Stress and Improves Circulation:
Proper circulation is vital to continued health. Your blood and
lymph carry nourishment to the trillions of cells throughout your
body and then carry away the waste to be eliminated from the cells.
Massage encourages a better exchange of nutrients at the cellular
level and more thorough detoxification. Remember, the future
"you" is determined by how well your army of cells
regenerate themselves, so this is indeed a critical part of
remaining healthy. Massage has been practiced for thousands of
years and is one of the earliest health treatments known to man.
That is why it remains one of the best ways of dealing with everyday
can improve digestive motility.
Flexibility And Range Of Motion:
reducing hypertonicity and hypotonicity the muscles allow for normal
ranges of motion to be restored. This also reduces the forces being
applied to the joint capsule and diminishes the potential for joint
and disk degeneration.
The Nervous System:
The first sense to develop is your sense of touch. It's not
surprising when you consider that each square inch of your skin
contains roughly 50 nerve endings. With as many as five million
total touch receptors in your skin relaying messages on to your
brain, your body's initial response to massage is to relax and
de-stimulate. Even a simple touch has been shown to lower blood
pressure and reduce the heart rate. Touch can also signal the brain
to produce endorphins, your body's natural pain suppressors. The
nervous system is your communication network, sending messages
constantly that determine proper functioning throughout your body.
Stress can affect the ability of the nervous system to do its job.
The many nerve endings found in the skin and muscles are soothed by
massage, and this contributes to keeping your internal lines of
communication open and operational.
Posture And Coordination
Massage is cost effective.
By assisting the client towards a quicker recovery from acute
headaches, neck and back pain, skeletal muscular strains, sprains,
etc. he or she is able to return to a normal productive life.
Massage also helps to prevent future chronic pain conditions by
effectively dealing with the cause of the problem and eliminating
it. It is shown in scientific literature that over 80% of the pain
is coming from soft tissue injuries, and over 74% is directly
attributed to Trigger Points. Overall Medical Massage achieves
results and substantial cost savings to the client, employer and to
society. As the general public becomes more familiar with the
role of the Medical Massage Therapist they will be better able to
handle their everyday soft-tissue pains.
powerful as Medical Massage Therapy can be, in certain cases it may
be contraindicated. Please consult with your physician or health
care provider to determine the
appropriate treatment protocol.