Massage, Insurance, and Taxes

What’s better than a massage?

One that your insurance pays for, of course!

While massage is considered a CAM (Complimentary and Alternative Medicine), Time Magazine recently published an article regarding research that has proven that massage can significantly decrease lower back pain, even after massage therapy services has ended. As well, Science Daily reported on research from Indiana University that shows massage provides substantial relief for low back pain in real world settings, not just in trials.

So, what does that mean for you? While most insurance companies do not cover massage services and most massage therapists do not accept insurance, you can still make it work.  There are several ways to be able to get affordable massage for pain relief:

1)      Insurance: It never hurts to try.  Call your insurance company to see if massage therapy is covered.  It will need to be prescribed by a doctor and have a medical necessity- you can’t get massage just to relax.

2)      HRA/HSA/Flex Spending: If your insurance won’t pay for massage outright, you may be able to use your HRS, HSA, or Flex spending to be able to pay for treatment. Many other CAM treatments such as acupuncture and chiropractic can be paid for this way as well. Once again, you will need a prescription from your doctor. As well, you will need an invoice from your massage therapist to submit, if requested to do so.

3)      Tax Deductions: If either of the first 2 options don’t work, the IRS states that massage therapy for medical necessity is a tax deductible expense.  Again, you will need a doctor's note and an invoice from the massage therapist. For more information, visit

4)      Massage Schools: If all else fails, massage schools offer discounted massages.  Check with local schools to see what stipulations they have (only relaxation, only certain issues, no pregnancy massage etc).  In New Jersey, it is against the Department of Education’s rules to be able to select a student therapist based on gender, sexual orientation, or race. As well, you do need to understand that you will be worked on by massage therapy students, not experienced massage therapists.

 I work at a massage school and have supervised massage clinics, as well as received many massages in clinics.  Do not expect the 5 star spa experience. Obviously, some students will be more experienced or more talented than others, but I have very rarely received a “bad” massage. In the clinic I supervised, massage tables were separated by hospital curtains.  In others, they had separate massage rooms.  Either way, students are supervised by experienced massage therapists who may correct them on technique or body mechanics.

 At around $35 locally to me, it’s a great deal for someone who wants massage but cannot afford to go to a more experienced professional.  That being said, it is important to know when the student therapists are not experienced enough to treat your condition.

To find a clinic, search “massage school” and your zipcode to find a close by school.

Some last tips:

1.       If you want your insurance or savings account to cover massage, you MUST have a prescription by a doctor, but that does not guarantee coverage. Ask your doctor to include a diagnosis and the duration and frequency that massage should performed.

2.       When submitting massage for reimbursement or keeping for either tax or savings account records, ask the massage therapist for a detailed invoice.  This must include the Date of Service, Diagnosis from prescribing physician, Service performed, duration, and cost.  Any credit card processing fees etc must be itemized as well.  Other services such as aromatherapy, reiki, or reflexology will probably not be reimbursable, but charges for the use of hot/cold packs are.

For example, at my client’s request, I will give them a fully itemized invoice of services rendered as well as a statement from myself explaining the medical necessity from my standpoint.

3.       Ask prospective massage therapists if they have experience providing itemized invoices (not receipts).  They may also be asked to provide their notes to insurance companies, so they must be prepared to do so.  If your massage therapist does not keep notes, that does not help to justify why you are getting massage and may result in the service not being covered.

While the world of insurance, spending accounts, and tax deductions can be complicated.  Hopefully, this summary will help you to make massage more affordable. As well, don’t be hesitant to contact your insurance company, spending account company, or the IRS for more information.