Is Massage Therapy Covered by UnitedHealthcare?
Yes.
UnitedHealthcare (UHC) may cover massage therapy when it is considered medically necessary and included in a physical therapy treatment plan prescribed by a physician. Coverage typically applies when massage therapy is part of a larger rehabilitation plan to treat specific medical conditions, such as injury recovery or chronic pain management.
However, UHC generally does not cover massage therapy as a stand-alone service. The therapy must be included in a physical therapy plan conducted by a licensed provider recognized by UHC. Long-term massage therapy is typically not considered medically necessary and may not be covered.
Coverage in Massage Therapy Offices:
In most cases, UnitedHealthcare does NOT COVER massage therapy provided by standalone massage therapists. UHC may not consider massage therapists as licensed providers eligible for insurance coverage.
Conditions for Massage Therapy Coverage:
- It must be prescribed by a licensed physician or healthcare provider.
- It must be part of a documented treatment plan for a medical condition.
- It must be conducted by a licensed physical therapist within the treatment plan.
- The medical necessity and effectiveness must be documented.
Pre-Authorization Requirements:
Yes. Pre-authorization is often required. Your healthcare provider must submit a treatment plan and supporting documents to UHC for review.
Limitations and Restrictions:
Coverage may be limited to a certain number of sessions and specific conditions. Full one-hour massages are generally not covered unless part of physical therapy.
Documentation Needed:
- A referral or prescription from a physician.
- A detailed treatment plan.
- Progress notes documenting effectiveness.
Finding Providers:
Check UHC’s provider directory for in-network physical therapists.
Is a PCP Referral Needed?
Possibly. This depends on your specific plan.
Reimbursement for Out-of-Network Services:
Partial reimbursement may be possible at a lower rate.
For More Information:
Visit UnitedHealthcare’s website or contact customer service.