AMTA continues to engage the Centers for Medicare and Medicaid Services (CMS) about full inclusion of massage therapy under Medicare Advantage programs as an option for members in licensed states who wish to be involved. In January, CMS wrote to all Medicare Advantage programs, taking it one step further to include massage therapy as a covered benefit. In their recommendations for 2020, they encourage the plans to cover massage therapy, rather than just saying it would be accepted by CMS as they indicated for 2019.
The CMS letter now says the following about “Non-Opioid Pain Management Supplemental Benefits”
“CMS encourages MA (Medicare Advantage) organizations to consider Part C benefit designs for supplemental benefits that address medically-approved non-opioid pain management and complementary and integrative treatments. For example, “peer support services” delivered by qualified individuals may be effective in facilitating recovery and assist in navigating health care resources. For purposes of completing the PBP, peer support services and/or psychosocial services/cognitive behavioral therapy can be included in counseling services (PBP 14c). In addition, non-Medicare covered chiropractic services (PBP 7b), acupuncture (PBP 13a), and therapeutic massage (PBP B14c) furnished by a state licensed massage therapist, may also be incorporated into plan designs. “Massage” should not be singled out as a particular aspect of other coverage (e.g., chiropractic care or occupational therapy) and must be ordered by a physician or medical professional in order to be considered primarily health related and not primarily for the comfort or relaxation of the enrollee. The non-opioid pain management item or service must treat or ameliorate the impact of an injury or illness (e.g., pain, stiffness, loss of range of motion).”
AMTA is continuing conversations with CMS to get more complete information on the plans that will offer massage therapy coverage for pain in 2019 and in 2020. As we learn more, we will inform our members and the entire profession.
Read more about Medicare Advantage plan choices and benefits in 2019. And, read the latest encouragement for more coverage in 2020.