Is Massage Therapy Covered by EmblemHealth?
Yes, with Certain Conditions.
EmblemHealth may cover massage therapy when it is considered medically necessary and included in a treatment plan prescribed by a physician. It must be part of a physical therapy plan carried out by a licensed provider recognized by EmblemHealth.
Coverage Details:
- Prescribed by a physician or healthcare provider.
- Part of a physical therapy treatment plan.
- Conducted by a licensed physical therapist.
Pre-Authorization:
Yes. Pre-authorization is often required for massage therapy.
Coverage Limits:
EmblemHealth may limit the number of covered sessions and only cover massage therapy for specific conditions. Long-term or maintenance treatments are not typically covered.
Documentation Required:
- Physician’s prescription or referral.
- Treatment plan detailing medical necessity.
- Progress notes from the physical therapist.
Finding Providers:
Consult EmblemHealth’s provider directory for in-network licensed providers.
PCP Referral Needed?
Possibly. Check your plan for requirements.
Reimbursement for Out-of-Network Services:
Partial reimbursement may be possible, but generally at a lower rate.
For More Information:
Visit EmblemHealth’s website or contact customer service.