By Matt Holton, LMT

This month’s therapy blog is going to be of a more practical nature.  Many times, clients who recognize the restorative and pain relieving benefits of massage have a difficult time budgeting their money in order to get massage frequently enough to maintain their bodies and make improvement on their health issues.  Economic times are tough, and it can be difficult to pay an expert massage therapist’s rates completely out of pocket.  There are alternatives to paying full price for massage without going to a cheap chain or waiting around for the next random Groupon offer.  One alternative is to use a Health Saving Account, which increasing numbers of employers are offering, to pay for massage therapy.

In order to be able to spend the funds in your HSA for massage therapy, you must first jump through a few hoops.  To be considered a qualified medical expense, IRS regulations state that medical care expenses MUST be used primarily to alleviate or prevent a physical or mental ailment.  In the IRS Publication 502 (see link below), receiving “therapy” is defined as a medical treatment.  Examples of illnesses that could qualify include carpal tunnel syndrome, tendonitis, stress, hypertension, back pain, sciatica, piriformis syndrome, fibromyalgia, arthritis, diabetes, chronic fatigue, anxiety, depression and pain management.

The first thing you must do is schedule an appointment with your doctor.  If you have been suffering from any of the above conditions, including stress, let him or her know that you are participating in an HSA and that you’d like to use some of your funds toward massage for treatment or prevention of your condition.

In order for your prescription to qualify, per IRS regulations, your physician will need to provide the following:

  1. Why do you need massage therapy? (A specific ailment or condition should be named)
  2. How frequent do you need treatment? (Example: 2 sessions per month)
  3. How long should you receive treatment? (Example: 6 months, a year)

After you’ve obtained your prescription from your doctor, keep it with your tax documents should you ever be asked to verify the expense in the case of an audit.  It is not necessary that your therapist receive a copy of your prescription, but it is helpful.  You can further your savings when using your HSA to pay for massage therapy by purchasing packages of sessions at a discounted rate.  These two tactics together (since HSA funds are withdrawn from your salary before taxes are taken out) can result in considerable savings when compared to paying for massage out-of-pocket with your post-tax income (approximately 30-40%!), putting regular massage therapy well within your financial reach.

Also, with the implementation of the new Affordable Care Act, you can pay for massages for a spouse and even dependents under the age of 27, if he or she has a qualifying medical condition.  To see if you are able use HSA funds for massage therapy, contact your physician for more information and a prescription for treatment.


IRS Regulations on HSAs and more: