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Healthcare Spending Accounts: What you need to know for yourself and your clients

Health Insurance and Massage

Being a healthcare practitioner in today's shuffling health insurance market is difficult, to say the least.

Every year the plans change and the costs go up, for both our small businesses and for our clients. It’s important to be able to help your clients understand how massage therapy is reimbursed in their accounts, keeping up on the process will allow you to gain more business and help more people.

Both FSA's (Flexible Spending Accounts) and HSA's are tax-advantaged accounts that let people save money to pay for qualified medical expenses, but they have a few important differences:

HSA (Health Spending Account):

An HSA is a tax-advantaged medical savings account for taxpayers in the US who are enrolled in a high-deductible health plan (HDHP). The money in your HSA can be used to help pay health insurance deductibles and medical expenses, including Dental and Vision care. The 2019 annual limit for contributing funds for individuals with single medical coverage is $3,500. The annual contribution limit is $7,000 for those covered under family medical plans. If money is withdrawn for qualified medical expenses, it is never taxed. However, If money is withdrawn for other purposes prior to age 65, you'll owe 20% taxes on the amount withdrawn. After age 65, money can be withdrawn without penalty.

FSA (Flexible Spending Account):

Flexible Spending Accounts (FSA's), also known as a Flexible Spending Arrangement, is established by an employer. Usually it's funded by a pre-tax payroll deduction, but employers can also contribute to it or provide it entirely. FSA's can be used in conjunction with any type of health insurance, although health insurance is not required to have one. FSA funds can be used to cover deductibles, copays, and other medical expenses like Vision and Dental. Some FSA's include a “Use it or lose it” clause, where the money not used in the account by the end of the year is forfeited back to the company. Employers can allow enrollees to carry over up to $500 to the next year, or use their funds during the grace period which ends on March 15th every year.

Massage Therapy is eligible for reimbursement with a Letter of Medical Necessity (LMN) with FSA's, HSA's, and health reimbursement arrangements (HRA's).

How to use HSA or FSA for Massage Therapy:

In some cases the first step in using your FSA or HSA money for massage therapy is to pay a visit to your primary care doctor. Let the doctor know you have an FSA or HSA and are seeking massage therapy as the solution to a medically eligible condition. The doctor will write a prescription for your massage if he/she deems it to be medically necessary.

The physician must provide three pieces of information on your prescription:

1. Why the massage is medically necessary

2. The number of sessions you'll need or the frequency of your visits

3. The length of the treatments needed.

Some clients will have a debit card directly linked to their spending accounts, but many will need the therapist to provide a form to submit for reimbursement.

The form should include:

1. The clients name and address

2. The Massage Therapist's name, address, and license number

3. The date and description of the service

4. The amount paid

5. The CPT (Current Procedural Terminology) code*.

*The most common code used for Massage Therapy is 97140 which is described as “manual therapy techniques.”

If you would like to be able to accept healthcare spending account debit cards you will need register as a healthcare practitioner with your POS (Point of Sale) service and provide your license number. The process is very easy and will allow you to receive funds instantly!

Massage Therapy is finally starting to be recognized as part of the medical community by physicians and insurance companies alike, and this recognition in conjunction with health spending accounts can be good for your business if you know how to navigate the billing process.

At Healing Touch we believe in preparing our students for the roadblocks of the business, helping them become confident in all aspects of the industry.

Dana Durand LMT, BCTMB

Founder & Educator of

Healing Touch Studies

For more information on HSA and Massage Therapy, please visit:


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