Massage Regulations by State

As I mentioned previously, I want to use this space to teach any and all interested massage therapists how to get credentialed with insurance companies, bill for insurance, and get paid. This will be vital knowledge when the bulk of the ACA rolls out next year and insurance coverage is expanded to include more consumers and providers.

You may not be able to use some of this information instantly. Maybe you’ll tuck it away until the time comes when your state allows you to join an insurance panel, or when your first insurance client schedules a massage with you. Regardless of whether your state yet allows you to do the things I’m teaching you how to do, I’ll continue to present this information throughout the coming months. I want you to be ready.

But which states already allow credentialing? Which states will allow credentialing? Section 2706 specifies that the non-discrimination law applies only to providers who are licensed or certified under state law. If a state doesn’t have laws in place for massage therapist licensing or certification, they will not be able to take advantage of the new law.

But that doesn’t mean all hope is lost. Indeed, many of the remaining states that don’t have state-wide requirements are pushing to make licensing or certification mandatory. Idaho, for example, will be requiring licenses for massage therapists starting in July. We still have the rest of the year to affect change elsewhere.

Below is a list of every state and their regulations on massage, along with a link to their massage therapy board or professional division. If you’re curious about how your state intends to transition with regards to the Affordable Care Act and massage therapy coverage, these are the people to ask.

Alabama – State license required.
Alabama Massage Therapy Board

Alaska – No state requirements or regulations.
Alaska Department of Commerce, Community, and Economic Development

Arizona – State license required.
Arizona Board of Massage Therapy

Arkansas – State license required.
Arkansas State Board of Massage Therapy

California – Voluntary certification for therapist or practitioner.
California Massage Therapy Council

Colorado – State registration required.
Colorado Division of Professions and Occupations

Connecticut – State license required.
Connecticut Department of Public Health & Addiction Service

Delaware – Optional state licensing. Can alternatively choose to be a Certified Massage Technician.
Board of Massage and Bodywork

District of Columbia – State license required.
District of Columbia Board of Massage Therapy

Florida – State license required.
Florida Board of Massage Therapy

Georgia – State license required.
Georgia Board of Massage Therapy

Hawaii – State license required.
Hawaii State Board of Massage Therapy

Idaho – State license will be required as of July 1, 2013.
Idaho Board of Massage Therapy

Illinois – State license required.
Illinois Department of Financial & Professional Regulations

Indiana – State certification required.
Indiana State Board of Massage Therapy

Iowa – State license required.
Iowa Board of Massage Therapy

Kansas – No state requirements or regulations.
Kansas State Business Licensure

Kentucky – State license required.
Kentucky Board of Licensure for Massage Therapy

Louisiana – State license required.
Louisiana Board of Massage Therapy

Maine – State license required.
Office of Licensing and Registration: Massage Therapists

Maryland – State license (LMT) or state registration (RMP) required.
Maryland Board of Chiropractic and Massage Therapy Examiners

Massachusetts – State certification required.
Massachusetts Board of Registration of Massage Therapy

Michigan – State license required.
Michigan Board of Massage Therapy

Minnesota – No state licensing; licensing is regulated by city or county.
Minnesota State Legislature

Mississippi – State license required.
Mississippi State Board of Massage Therapy

Missouri – State license required.
Missouri State Board of Therapeutic Massage

Montana – State license required.
Montana Board of Massage Therapy

Nebraska – State license required.
Nebraska Department of Health and Human Services

Nevada – State license required.
Nevada State Board of Massage Therapists

New Hampshire – State license required.
New Hampshire Department of Health and Human Services

New Jersey – State license required.
New Jersey Board of Massage and Bodywork Therapy

New Mexico – State license required.
New Mexico Massage Therapy Board

New York – State license required.
New York State Board of Massage Therapy

North Carolina – State license required.
North Carolina Board of Massage and Bodywork Therapy

North Dakota – State license required.
North Dakota Board of Massage

Ohio – State license required.
State Medical Board of Ohio

Oklahoma – No state requirements or regulations.
Oklahoma Board of Medical Licensure and Supervision

Oregon – State license required. Insurance credentialing available.
Oregon Board of Massage || Oregon Practitioner Credentialing Application

Pennsylvania – State license required.
Pennsylvania State Board of Massage Therapy

Rhode Island – State license required.
Rhode Island Department of Health

South Carolina – State license required.
South Carolina Massage and Bodywork Panel

South Dakota – State license required.
South Dakota Board of Massage Therapy

Tennessee – State license required.
Tennessee Board of Massage Licensure

Texas – State registration required.
Texas Department of State Health Services

Utah – State license required.
Utah Division of Occupational and Professional Licensing

Vermont – No state requirements or regulations.
Vermont Office of Professional Regulation

Virginia – State certification required.
Virginia Board of Nursing

Washington– State license required. Insurance credentialing available
Washington State Department of Health || Washington Practitioner Credentialing Application

West Virginia – State license required.
West Virginia Massage Therapy Board

Wisconsin – State certification required.
Wisconsin Department of Safety and Professional Services

Wyoming – No state requirements or regulations.
Wyoming Professional Licensing Boards

2706 Details

What does Section 2706 mean?

I spoke on the phone this weekend with Judge Deborah Senn, former WA insurance commissioner who helped to design the Every Category law that covered CAM providers in her state. She explained to me the meaning and intent of Section 2706 of the ACA, and what it means for both insurance policies and providers.

[Health insurance] shall not discriminate…against any health care provider.

This law is specifically written to cover providers, not services. That means that insurance policies can no longer cover massage therapy only when performed by a chiropractor or doctor, which is something that they love to do. If massage is indicated, any provider who is licensed to perform massage will be covered. That means us.

If a client wants to use health insurance to get a massage, he or she may be required to get a doctor’s referral first. If a doctor determines that massage therapy is a good course of action for the diagnosis given (eg, back pain, neck pain), then insurance will have to cover the massage, regardless of the type of practitioner that gives it (given, of course, that said practitioner is working within his or her scope of practice).

Massage therapists will have to be credentialed with insurance companies in order to work with them, and although this can be tiresome, it has significant benefits (which I will explain later). Beyond that, the new law makes everything pretty straightforward. If your doctor says you should get a massage, insurance will cover it. Simple!

That said, you can be absolutely sure that insurance companies will only comply with this while kicking and screaming. As the ACA rolls out in full at the beginning of 2014, the first few months especially will be rather frustrating. It will be up to us, the providers, to make sure that both our clients and ourselves can get the most benefit out of Section 2706.

I hope that this blog will be able to serve as a guide to dealing with insurance companies – beyond getting credentialed and billing for services, I want to show you the ways that these companies will try to deny your claims. I want you to know your rights under the law. I want to teach you navigate the waters of insurance and get yourself paid. It’s going to take some extra effort, and I know that not every LMT will want to deal with the extra hassle. But the more massage therapists who do, the greater our rewards will be.

LMT Interview: Lisa

Name: Lisa

Name of your practice: Lisa L Romary LMT

Location: Beaverton, OR

Number of LMTs working there: Myself

How long have you been massaging? 12 years

What type(s) of massage do you do? Trigger point therapy

How long have you taken insurance? 10 years

What types of insurance cases do you accept? MVA, worker’s comp.

Do you do your own insurance billing? Yes

What’s your favorite part about taking insurance? I love the work. The challenge of working with the client to help them relieve their pain, and assisting them in transition to normalcy.

What’s your least favorite part about taking insurance? The games the insurance companies play.

What do you hope the new ACA laws will accomplish? I am hoping that it will assist every person to health care regardless of income.

What would you say to an LMT who is interested in taking insurance? The money can be very good. Especially if you can connect/work with health care professionals to give you referrals. Insurance is a lot of extra time and paperwork. You have to perform massage that is result driven. I have found neuromuscular therapy and trigger point therapy works well with MVA and Workman’s comp claims. In my early practice, I offered and performed many free massages on Chiropractors, PT’s, physicians, dentists, etc. to build business. It is very physically demanding and is difficult to sustain the demands on the body, long term.

Are you also an LMT who takes insurance? Fill out your own survey here!

LMT Interview: K. Nuce

Name: Kathleen Nuce

Name of your practice: Kathleen Nuce, LMT

Location: I visit homes.

Number of LMTs working there:

How long have you been massaging? 20 years.

What type(s) of massage do you do? Chronic pain

How long have you taken insurance? 20 years!

What types of insurance cases do you accept? W/C, Blue Cross

Do you do your own insurance billing? Yes!

What’s your favorite part about taking insurance? I’m always happy to serve my clients.

What’s your least favorite part about taking insurance? It’s all part of the job. The phone calls, the paperwork, the waiting for reimbursement!

What do you hope the new ACA laws will accomplish? I hope that people will have choices and opportunities to have their health needs met in a timely manner.

What would you say to an LMT who is interested in taking insurance? I often encourage newbies to serve their clients by offering this service however most would rather accept lesser monies for,their service than wait for reimbursement. I always offer to show them the ropes! In twenty years, no one has accepted the challenge!

Are you also an LMT who takes insurance? Fill out your own survey here!

LMT Interview: C. Hill

Name: Cecelia M. Hill

Name of your practice: New Hope Natural Healing

Location: Port Charlotte, FL

Number of LMTs working there: Five

How long have you been massaging? 22 years

What type(s) of massage do you do? All types.

How long have you taken insurance? 20 years

What types of insurance cases do you accept? Any type that will pay. FL just cut out LMTS from PIP. It added to our bottom line.

Do you do your own insurance billing? No. Used to, but management went to a service.

What’s your favorite part about taking insurance? Because you can itemize for modalities, I feel you get paid for what you are worth. Clients are more capable of coming when they need services. I feel they get a much better result when they don’t have to worry about out of pocket expense.

What’s your least favorite part about taking insurance? Fighting with the insurance co. They are all different. You can use a code with one and another one wont except the code. Takes time away from what I’m supposed to be doing.

What do you hope the new ACA laws will accomplish? I hope it will open up holistic care for everyone. I also do acupuncture and people would be so much healthier if they could avoid drugs and surgeries. I also work at an exclusive spa where money is no object. I really feel money can buy health. If every one had equal access everyone could be healthier .

What would you say to an LMT who is interested in taking insurance? Need to make your practice at least 1/2. If it’s all insurance, things get lost in the pipeline and cash flow stops. Get a service if you have a lot of ins cases – they can bog you down and instead of taking care of people you are buried in red tape with no money.

Are you also an LMT who takes insurance? Fill out your own survey here!

How to Take Insurance (1) – NPI Number

What is an NPI number?

NPI stands for National Provider Identification, and it is exactly that. It’s a 10-digit number that all medical providers (and/or medical facilities) use with electronic health transactions.

Why do I need an NPI number?

Title II of HIPAA, the Health Insurance Portability and Accountability Act created in 1996, requires the establishment of national standards for electronic health care transactions, as well as national identifiers for providers, insurance plans, and employers. Having these national standards in place helps to address and maintain the security and privacy of health data.

If you have online intakes or charts, or if you bill insurance companies or receive payment electronically, you need an NPI in order to follow proper HIPAA guidelines.

Using an NPI number makes a lot of sense. Let’s say you call an insurance company to check on a client’s benefits. The operator needs to know who you are. Do you give them your insurance-company-specific Provider Number? Your state license number? Instead having every one of these numbers for every single provider immediately accessible in their database, insurance companies just need to focus on one number type* across all medical professions. Makes the whole process a lot more streamlined.

How do I get an NPI?

You can easily get an NPI by going to the National Provider System. Click on the link that says “Apply Online for an NPI”. The process only takes about 20 minutes.

What should I do after I get my NPI?

Write it down. Memorize it. Love it.

How do I learn more?

Check out the FAQs on NPI numbers here!

* Well, almost one. You still need to give your TIN (that is, your SSN or EIN) along with you NPI when you submit a HCFA to bill for services. Many insurance companies are starting to move towards “NPI only” in other areas, though, such as using the provider website or checking on benefit information.

LMT Interview – M. Thies

Name: Mary Thies

Name of your practice: Mary Thies Massage

Location: Portland, OR

Number of LMTs working there: 1

How long have you been massaging? 7 years

What type(s) of massage do you do? Pediatric, oncology

How long have you taken insurance? 5 years

What types of insurance cases do you accept? Medical, PIP, L&I

Do you do your own insurance billing? Yes.

What’s your favorite part about taking insurance? Clients are able to see me who could not afford it out of pocket as a luxury.

What’s your least favorite part about taking insurance? The paperwork.

What do you hope the new ACA laws will accomplish? Expand coverage for medical massage therapy for the millions of Americans who need this kind of specialized treatment!

What would you say to an LMT who is interested in taking insurance? Start today, just investigating one part of the process. It takes a long time to get credentialed, so don’t be discouraged. Better to start today!

Are you also an LMT who takes insurance? Fill out your own survey here!