Health Insurance

Having health insurance that covers massage can definitely make care more affordable and accessible. Here are some good things to know about working with your health insurance plan.


Am I covered?

Does your health insurance policy have massage therapy coverage? Want to find out? Click the link below and submit your insurance information and we will find out for you!

We will let you know as soon as we receive your verified health coverage information, and get you set up to make the most of your health insurance benefits right away!

Please note that coverage varies widely from plan to plan. We recommend you contact your insurance company directly to learn the details of your policy on an annual basis. You are ultimately responsible for the cost of your care, regardless of what happens with your insurance claim.

*The Grove requires prior authorization of health insurance coverage. To book a session using insurance coverage, you must first have submitted and received verification of your coverage from The Grove, even if you know you have coverage. If we have not received your verification prior to your scheduled appointment, you will be charged in full at the time of your appointment and we will reimburse you the session fee minus your copay once we have received your coverage verification.


Good questions to ask your insurance company or HR department:

  • Is massage therapy covered with a licensed massage therapist? (Sometimes, it is only covered with a PT, DC or MD.) Is my massage therapist considered in-network with this plan? If not, do I have out of network coverage?
  • Do I have a deductible (an amount of money that you pay out each year before your coverage kicks in)? If so, has it been met yet? Does it apply to massage therapy coverage? What is the allowed amount (this is the amount we agree to accept per the contract with your insurance company) per visit for CPT code 97124 or 97140 (four units = a 60 minute session)? This allowed amount is not the same rate we charge and accept for payment at the time.
  • Is there a visit limit or monetary limit? And, do other forms of care count towards the visit limit? (Often, massage is part of a rehab benefit, which includes PT and other forms of care, or an alternative care benefit, with acupuncture and nutrition.)
  • Do I have a copayment? Or coinsurance? How much is it?

Motor Vehicle Accidents (MVA)

Massage therapy can be a great resource for treating common injuries sustained in an automobile accident, such as whiplash, headaches, neck pain, fatigue, sleeplessness and back pain. If you’ve been injured, we’d love to help. To get the ball rolling…


See your doctor

First, see your doctor or chiropractor for an exam and assessment and to discuss your treatment options. If your doctor feels massage therapy could be helpful, ask for a prescription for massage. (Your doctor may email it to us at contact@thegrovegp.com)


Send us your claim information

Please send us the following as soon as possible via email or phone:

  • Name of the auto insurance company
  • Your claim number
  • Date of the accident
  • Name and phone number of the person managing your claim (sometimes called a claim adjustor)

Ideally, the insurance information you provide to us will be for a claim that you have opened with YOUR auto insurance company, regardless of who is at fault. This potentially enables your medical providers to be paid for your care as the costs accrue via the Personal Injury Protection (PIP) policy that is probably available on your insurance policy. (As we understand it, opening a claim with your insurer should not impact your premiums if you are not at fault.) Without PIP coverage, you may be able to use your health insurance or we can discuss other payment options.


Prescriptions

A prescription is required for any care covered by health insurance, even if your plan doesn’t explicitly require it, because nearly all coverage for massage is based on the documented medical necessity of the care. As massage therapists, we cannot diagnose conditions, and therefore, cannot confirm officially that your care is medically necessary in the eyes of an insurance plan.

A prescription from your doctor should include:

  • A start and end date (If your doctor recommended four visits once a week, the script expires four weeks from the start date.)
  • An ICD-10 diagnosis code for a musculoskeletal system problem or related issue
  • The number of visits recommended

NOTE: We will focus on the areas noted on the prescription.

Your doctor may email us your prescription to contact@thegrovegp.com or mail it to 227 NE Hillcrest Drive, Grants Pass, Oregon 97526.

To schedule an initial insurance session, please contact our office.