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You may have extended health benefits through a workplace group insurance plan that covers massage therapy provided by an RMT. Coverage varies as does the requirement of a physician’s referral. Please check with your plan for massage therapy coverage and plan details.
Some RMTs will direct bill your extended health plan. Ask your RMT to see if direct billing is available and what their policy is.
Most major insurance benefit programs will only approve massage therapy provided by a Registered Massage Therapist who has graduated a full program to allow the treatment to be billed under the benefit plan because it increases the effective health benefits AND reduces the injury risks when a minimum standard of education has been achieved by the practitioner.
This assures the insurers and the companies who provide your benefits that your health care is being managed by someone with minimum competencies and who is held to a high standard of care.
For a massage therapy treatment to be eligible for reimbursement it must include a health history/ongoing update, assessment, treatment that is within the RMT’s scope of practice and as appropriate, remedial exercise and/or home care recommendations.
In most cases, a referral is not required to see a massage therapist. However, certain healthcare plans or insurance providers may have specific requirements, so it’s best to check with your insurance company or healthcare provider to determine if a referral or prescription is needed for insurance coverage purposes.
If a prescription is required by your insurance plan, it must be issued before or on the date of the massage.
RMTs follow best practices as outlined by the Canadian Life and Health Insurance Association. The following information must be on a massage therapy receipt for you to be able to submit is for insurance reimbursement:
Receipts should accurately reflect the purchase of a gift card/certificate. Insurance does not cover gift card/certificate purchases.
Insurance does not cover missed or canceled appointments.
Check with your RMT regarding their policy for missed appointment charges.