Is Massage Therapy Covered by Cigna?
Yes.
Cigna’s coverage for massage therapy varies depending on the specific terms of an individual’s benefit plan. Generally, massage therapy is covered when it is part of a comprehensive treatment plan that includes other therapies, such as physical or chiropractic therapy.
Standalone massage therapy sessions are typically NOT COVERED.
Massage Therapy coverage criteria are as follows:
- Massage Therapy is considered medically necessary when provided as a component of a covered physical therapy, occupational therapy, or chiropractic treatment plan.
- Must be prescribed and documented by a physician.
- Massage Therapy must be prescribed by a qualified healthcare provider and administered by a licensed therapist.
Does Massage Therapy Need Pre-Authorization?
Yes.
Cigna’s coverage for massage therapy varies depending on your specific health plan. Generally, massage therapy IS covered when it is part of a comprehensive treatment plan, such as physical therapy, and is deemed medically necessary.
In such cases, pre-authorization is often required.
Limitations:
There may be restrictions on session numbers. Full massages are usually not covered unless they are part of a physical therapy plan.
Do I Need A Referral From My PCP?
Depends On Your Plan.
Cigna’s requirement for a referral from your Primary Care Physician (PCP) for massage therapy services depends on your specific health plan. Here’s a general overview:
Plan Types and Referral Requirements:
- HMO and Network Plans: Typically, these plans require a referral from your PCP to see a specialist, including for services like massage therapy. Cigna
- POS Plans: These plans often require a PCP referral for in-network specialist services. You may access out-of-network providers without a referral, but staying within the network with a referral usually results in lower out-of-pocket costs. Cigna
- Open Access, PPO, and Indemnity Plans: Generally, these plans do not require referrals, allowing you to see specialists, including massage therapists, without prior authorization. Cigna
Are There Limits To Massage Therapy Coverage?
Yes.
Cigna’s coverage for massage therapy is subject to specific limitations and varies based on individual benefit plans. Key considerations include:
1. Plan-Specific Exclusions:
- Some Cigna plans explicitly exclude massage therapy from coverage, categorizing it under complementary and alternative medicine services. Cigna
2. Medical Necessity and Integration:
- Massage therapy may be considered medically necessary when integrated into a broader treatment plan, such as physical or chiropractic therapy. In such cases, it must be prescribed by a qualified healthcare provider and administered by a licensed therapist. Cigna
3. Limitations on Duration and Frequency:
- Even when covered, massage therapy is typically subject to limitations regarding the number of sessions or duration of treatment. These specifics are outlined in the Short-Term Rehabilitation Therapy or Chiropractic Care Services sections of your plan’s schedule of copayments. Cigna
Cigna’s Massage Therapy Coverage Limits and Exclusions
How Do I Find A Facility That Offers Massage And Accepts Cigna Insurance?
Use Cigna’s provider directory to find providers here.
More Information About Cigna and Massage Therapy
For more information about massage therapy and other alternative medicine treatments, visit one of the following links:
Cigna Healthcare Policies | Member Rights and Responsibilities
Cigna Medical Coverage Policy | Massage Therapy