Massage Therapy Guidelines

Massage therapy is covered only when used to diagnose, treat, or evaluate musculoskeletal conditions (and specifically included non‑musculoskeletal conditions: cancer pain as an adjunct to oncologic care and fibromyalgia) with a direct therapeutic relationship to the region of complaint; maintenance/preventive/palliative care (except limited cancer adjunct), non‑included non‑musculoskeletal disorders, treatments lacking standardized outcome measures, care exceeding medically necessary frequency/duration, contraindicated conditions, or services that replace/delay necessary medical care are excluded. Coverage requires documentation of diagnosis, baseline and repeated standardized quantitative outcome measures demonstrating clinically meaningful improvement (MCID/MDC or equivalent) for initial and continuation requests, plus condition‑specific co‑management details for cancer care.

"Massage Therapy Services medically necessary when needed to diagnose, treat, or evaluate an injury, illness, condition, or disease that is musculoskeletal in origin in order to reduce pain or resto..."