Massage Insurance Billing…Where to Start

One of the common questions I get asked on a regular basis is “how do I get started in Massage Insurance Billing?” or “how do I bill insurance companies and get them to reimburse me?”.  While I do not consider myself an expert in the field of massage insurance billing, I do bill insurance companies in my own practice for reimbursement and make a wonderful living doing so.

I was blessed to have gone to a great school that focused on SOAP notes and how to interact with attorneys, insurance companies and workers compensation.  What my education did lack was exactly how to go about billing the insurance companies.  When I opened up my business and began to work in the chiropractic clinic I was lost, confused and extremely intimidated.  The only thing I knew was how to do a client intake and chart my session on my SOAP notes.  Thankfully however, I was again blessed and worked with an amazing chiropractor and massage therapist who were willing to walk me through a few things on how to get started.

However, you may not have the same experience I did and be left wondering “how do I even get started?”.  If you don’t have a mentor walking you through everything, chances are you aren’t going to know what you are doing.  Massage insurance billing is like playing with the big dogs and you better know what you are doing or prepare to face overwhelming feelings of frustration and tons of valuable time wasted.

But there is light at the end of the tunnel.  Thankfully, there are resources to turn to when learning the ropes of massage insurance billing.  We are blessed to have some great educators and mentors in our field that have paved the way for our success.

Here are my 2 recommendations for learning massage insurance billing

The first resource I want to highlight is something that was a required purchase while I was in school.  I am so thankful it was! Hands Heal: Communication, Documentation, and Insurance Billing for Manual Therapists by Diana L. Thompson is a must have for any massage therapist needing to learn the ropes of massage insurance billing.  Diana does a great job highlighting SOAP charting, communication with insurance companies, intake forms, ethics and more.  Diana has saved me many times when a physician requests a progress report for a patient.  I just go over my SOAP notes from  the specific client sessions and turn to her page on how to prepare a professional progress report.  I feel confident knowing I can supply a physician with a professional, thorough progress report that makes me stand out as a competent, educated, professional massage therapist.  This book is a must read for any massage therapist needing a mentor in learning massage insurance billing.

The second resource I highly recommend is Vivian Madison-Mahoney’s Massage Insurance Billing course.  This is an in depth, thorough, training program that educates and teaches exactly what you need to be doing to become an insurance provider, how to fill out the necessary forms, how to bill correctly, what you can bill for, codes, forms, you name it…Vivian teaches it.  Since 1984 Vivian has been involved in our industry as a massage insurance billing expert.  She knows massage insurance billing on every level and has made it possible for you to learn at a fraction of the time and expense it has cost her over the years.  There isn’t anything to think about when deciding on whether or not you are going to purchase this course.  After just 1 client you will have made your money back.  This course is a must have!

While some may argue that massage insurance billing isn’t worth the time and effort it takes, I disagree.  I am blessed to live in Washington State and have the ability to become an in network provider for private health insurance companies.  My practice grew in only a matter of a few months when I made myself available to bill through insurance companies for my clients.  While not every state does offer the availability to bill through a persons private health insurance, it is my understanding that in nearly every state you are automatically able to bill through PIP (motor vehicle accidents) as well as Labor & Industries (workers compensation/on the job injuries).  Vivian explains all of this in her Massage Insurance Billing course.

If you are deciding on becoming an insurance provider in your massage practice please take a few things into consideration.  While it does open up your doors to more clients and does provide an extra income stream, it is NOT easy work, especially when getting started.  I don’t want to scare you away into thinking it’s impossible, quite the contrary.  Massage insurance billing is very possible and can provide a great additional stream of income to your business.  But, there is work involved in learning the process and actually taking the right steps to do it correctly.  If you are willing to take the time it can be very rewarding.  Consider if you are willing to wait 4-8 weeks to be reimbursed, sometimes longer.  Consider if you are willing to spend the time talking on the phone with insurance companies if your claims get denied.  Consider if you want to take on this extra responsibility.  Because I am a believer in multiple streams of income,  I would do it again in a heartbeat!

On another note, if you are a Washington State Massage Therapist and are interested in how you can become credentialed with the private health insurance companies that are available to us, please visit the follow links:


Premera Blue Cross/Lifewise

First Choice Health

United HealthCare/Pacificare

American Specialty Health (Aetna, Cigna, Uniform, Corvel)

Labor & Industries

I hope this has helped jump start your career towards becoming an insurance provider.  If you know of any other great resources in learning insurance billing I would love to hear them.  Best of luck on your journey!

Wishing You Much Success,

Ann Ross

7 thoughts on “Massage Insurance Billing…Where to Start

  1. Jessica Wegale

    I am going to share the other side of the coin. I am in MA. where you cannot bill health insurance you give the person a 20% discount everytime the client comes in. Which I did sign up to do and was not a money maker for me.

    And the going rate for PIP & worksmen’s comp. in my state it is $40 per hour. The way you make more money is to piggy back codes with each client.

  2. Ann Ross Post author

    Hi Jessica,

    Thanks so much for sharing your experience with insurance. Based on what you are saying, is it hard to make a living billing insurance? I know that each state is entirely different.


  3. Jessica Wegale

    If you know the codes to piggy back services, MRF, Trigger Point, hot & cold packs etc… and have them also listed with your NPI number. You can make more money, about $80 per hour with clients co pay.

    A well est. MT in my area can make $80 per hour without taking insurance. I know Mt’s do it to build up their name and then drop the insurance once they have an est. client base

  4. Vivian M. Mahoney

    Ann Wow, thank you for the recomendation!! I never saw this page or site from you before and was so thankful for the kind words you said about my courses etc.

    It never ceases to amaze me how so many do not get it right and wonder why they are paid so little or not at all. There are guidelines but many do not want to go to the well where the water is, if you know what I mean, they try to piece meal it all with bits and pieces of information they get from others who also do not know the ins and outs of insurance billing.

    I have to say, I am getting a bit weary of trying to straighten out the problems everyone has who end up telling me they did it this or that way because so and so told them or that this is the way they “heard it should be done.”

    I so wish I could stand on a mountain top and tell the massage world that “This is the way to do it correctly, be paid and put the money in the bank.” But doing it one therapist at a time has been difficult to say the least.

    When it is done correctly the payment is worth it in most cases, I too had to learn the hard way, but because no one was available to train me back them.

    I also find that massage therapists will be willing to lose hour after hour and dollar after dollar to try it and end up doing it incorrectly rather than invest a bit of time and a minimal amount of money to learn the professional aspects of billing and being paid by insurance companies, as they were willing to do to become a massage therapist in the first place.

    I do wish all who accept insurance the very best because the success of each builds the success of our profession in the health care arena.

    Many do not realize that with a purchase of any of my seminars, home study courses, manuals and/or DVD’s that they get a year of FREE consultation whereby I am there for them by email or phone to help them on current situations as they arise.

    I have been instructing therapists in this field of insurance since 1990 and hope to continue as long as I possibly can because of the ever growing need for therapists to get it right!

    Thanks so much Ann!!!!!

  5. Ann Ross Post author

    Vivian, thank you SO VERY MUCH for reaching out on the topic of insurance billing. You are the queen after all! 😉 I highly encourage all therapists to learn insurance billing as it can be a wonderful asset to one’s practice. Particularly PIP (car accidents). I often speak to therapists who are struggling in their business to attract clients and ask if they work with PIP. Most assume they can’t and are surprised when I tell them that they in fact can. I always send them your way as you know so much about how do to it the right way. Doing it the right way is so very important when working with insurance. While it can be a learning curve in the beginning, investing in a course with you is the perfect way to learn correctly from the beginning so that there are less errors and issues along the way. I highly encourage all MT’s to reach out to Vivian at and take her course. It will be one of the greatest investments in your career. Thank you, Vivian for being the pioneer of insurance billing for all MT’s and for paving the way for us so that we all can have successful careers. We appreciate you! Much love! ~Ann

  6. Jeannien

    Thanks for the input about billing for massage therapy. In school we were discouraged to take insurance as massage therapis, did not focus on proper SOAP charting (only spent 2hrs on it and was told it was to much of a hassle. Once out of school my first client was a PIP Client and basically had to learn on My own. I worked hard and focused on becoming cradentialed with several insurance comanys, paying off I am now credentialed with Regence, Premera and the healthways groups. I am still learning and will now check out the information you have posted above.

    My question to you is I have a PIP claim that has gone into 3rd party with an outstanding balance. I was told that we can charge a compond interest on this now that I am holding this account till they settle. Do you charge a compound interest and what is the average persentage of that compounded interest (I was told 4% but that seems very high)?

    Please help with any info as I am on a time crunch, the attorneys have asked for my itemized statement.

    Thanks for all your help

  7. angel

    This question is directed to Vivian. I was looking at your products and not sure which one to purchase. I live in the state of Hawaii and have been practicing for over 17 years. I’ve had some experience with insurance billing through working with other people but it was just filling out Soap notes. I never directly billed the insurance co’s. Please tell me which item would be best for me.


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