Medicare, Medicaid, Medicare Supplemental & Advantage Plans

Rev. 09/11/2024

Medicare Advantage (MA) Plans

Commercial Medicare Advantage (MA) plan insurers in New Hampshire do not currently contract with licensed massage therapists. Therefore, we remain out-of-network providers for medical massage referrals for evaluation and treatment covered as additional benefits under certain MA plans. This means that if your Advantage plan is a Health Maintenance Organization (HMO) plan, we will NOT be able to file claims for you.

If you are a Medicare Part C Advantage beneficiary with a PPO plan and your plan includes medical massage as a covered benefit, we may be able to file out-of-network claims to your plan on your behalf. Please see this Center for Medicare & Medicaid Services letter from 2018 (pg. 3, para. Medically-Approved Non-Opioid Pain Management).

As with our veteran patients, your doctor must refer you to our clinic for evaluation and treatment stating medical indication. Request this referral from your physician directly. Your healthcare provider will need to evaluate you initially or they will have to have treated you in the past for your pain condition in order to send a referral to us. A referral may take several days to reach us.

How To Proceed

If you have a Medicare Part C Advantage Plan:

  1. Call your plan’s customer service number and ask them to confirm that medical massage is covered under your PPO plan and what the specifics are (deductibles, copays, co-insurance, other costs to you, number of visits, etc.).
  2. Call your doctor’s office, ask for a referral for Myoskeletal Alignment Therapy or medical massage for your musculoskeletal pain condition, pathology, prehab/rehab, etc. to be sent to Manchester-Bedford Myoskeletal LLC by mail or faxed to us on (888) 965-6870.
  3. When we receive the referral, we will call you for a short phone consultation and set up your initial visit. We will take your insurance information over the phone in order to confirm plan coverage with your insurer and determination whether precertification is required. If coverage is denied, we will let you know the reason and may appeal the decision.
  4. Once everything is in place, we will email you confirmation of your appointment, visit instructions, and clinic forms for you to complete before coming in for your initial visit.

Medicare / Medicaid

To our great regret, we remain unable to file claims for Medicare, Medicaid, Medicare Supplemental, or MediGap plans as the Centers for Medicare & Medicaid Services (CMS) specifically names licensed massage therapists as ineligible to enroll as either participating or non-participating providers.

The Struggle Is Real

Please be sure that we here at Manchester Bedford Myoskeletal continually advocate for access to commercial healthcare networks for our patients’ benefit as we only provide medical musculoskeletal therapy for pain management. We do not provide relaxation massage services except when specifically physician referred for anti-opioid pain management and cancer stress-related therapy.

You can self-advocate by urging your insurance company and New Hampshire legislators to make exceptions for and include state licensed massage therapists who provide clinical massage services on physician referral. Some of us want to serve the insurance patient sector (most don’t!) and contract as in-network providers with insurers who sell medical insurance policies in our state.