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HSA & FSA

Use your HSA or FSA for therapeutic massage.

If you've got pre-tax health dollars sitting in an HSA or FSA, therapeutic massage is often eligible — when there's a medical reason behind it. Here's how it works, what we accept, and what you'll need from your doctor.

The short version

Three things to know.

  1. 1

    Therapeutic massage is often eligible when there's a documented medical condition behind it — chronic pain, recovery from injury or surgery, pregnancy support, anxiety, migraines, and similar.

  2. 2

    You'll usually need a Letter of Medical Necessity from your doctor. It's a short note — diagnosis, recommendation, frequency. Most plans want one on file.

  3. 3

    We accept HSA and FSA cards at checkout. If your card declines, pay another way and we'll give you an itemized receipt to submit for reimbursement.

Plan rules vary. We can help with documentation, but only your HSA or FSA administrator can confirm what's covered under your specific plan.

Quick reference

What's typically eligible

A starting point — final eligibility is up to your plan administrator.

Often eligible

  • Therapeutic massage with an LMN
  • Deep tissue for chronic pain
  • Prenatal massage
  • Post-surgical lymphatic drainage
  • Reflexology for documented conditions
  • Sports / injury recovery massage

All require a Letter of Medical Necessity except where the medical reason is already documented in your plan.

Not eligible

  • × Relaxation massage (no LMN)
  • × Couples massage
  • × Eminence Organics facials
  • × Waxing services
  • × General memberships
  • × Retail products

For these, plan on paying with a regular form of payment.

Step by step

How to use your account

1

Talk to your doctor

If you have a chronic pain condition, are recovering from surgery, are pregnant, or deal with anxiety or migraines, ask your doctor whether massage therapy is medically appropriate. If yes, ask for a Letter of Medical Necessity.

2

Get your LMN

A Letter of Medical Necessity is a short note from your provider stating the diagnosis, why massage is recommended, and the suggested frequency. Your HSA or FSA administrator may have a specific form they prefer — check their portal first.

3

Book your session

Book any therapeutic massage that fits your need — deep tissue, prenatal, lymphatic, reflexology. You don't need to do anything different at booking. Mention your situation if you have specific requests.

4

Pay and document

Use your HSA or FSA card at checkout, or pay another way and request an itemized receipt. Keep your receipt and LMN together — your plan may ask for both during a routine audit.

What to ask your doctor

Getting your Letter of Medical Necessity

It's a short, clinical letter. Most providers can write it during a visit or upload it through your patient portal in a few minutes. Bring this list with you so they have what they need.

  • Your diagnosis or condition — Be specific — chronic low back pain, sciatica, prenatal back pain, post-surgical lymphedema.
  • Why massage is recommended — A short clinical reason — pain management, mobility, recovery, lymphatic drainage.
  • Frequency and duration — How often (e.g., weekly, biweekly) and for how long (months, ongoing).
  • Provider info — Their name, credentials, NPI, and signature.

Some HSA and FSA administrators have a fillable LMN form on their member portal. Check there first — it's faster than a custom letter.

Sample · for reference only

Letter of Medical Necessity

To Whom It May Concern,

I am the treating physician for [Patient Name], who has been diagnosed with [condition]. I am recommending therapeutic massage as part of their treatment plan to address [symptom or goal].

I recommend treatment [frequency] for an initial period of [duration], with continued sessions as clinically indicated.

Please consider this letter authorization to use HSA / FSA funds toward this care.

[Provider Name, Credentials, NPI]
[Signature, Date]

Not legal or tax advice. Use as a starting point only — your provider will adapt it for your situation, and your plan administrator may have a specific form they prefer.

From our side

What we'll provide

If your card doesn't go through or your plan needs paperwork, we've got you.

Itemized receipt

Date, service, duration, amount, our business info, and a transaction ID — everything most plans ask for.

Provider details on request

Therapist name, license number, and our NPI if your plan needs them on the receipt.

Help filing your claim

If your plan has questions about a charge, call us and we'll send what they need. We don't bill insurance directly, but we make filing easy.

Important

We provide this guide for general information only. We are not tax advisors, accountants, or insurance brokers, and IRS rules and HSA / FSA plan terms can change. Final eligibility is determined by your plan administrator and your tax situation. When in doubt, check your member portal or call your plan's customer service line — your card itself is usually the fastest way to reach them.

FAQs

Common questions

Is therapeutic massage HSA or FSA eligible?
Often, yes — when it's prescribed for a specific medical condition. The IRS allows HSA and FSA funds to cover medical care, and many therapeutic massage sessions qualify when there is a documented health reason. Common qualifying conditions include chronic pain, sciatica, fibromyalgia, recovery from surgery or injury, anxiety, and migraines. Plan rules vary, so check with your administrator before booking.
What about relaxation or "spa" massages?
General relaxation or wellness massage without a documented medical reason usually isn't eligible. The deciding factor is medical necessity, not the technique used.
Do I need a prescription or letter of medical necessity?
Most plans require a Letter of Medical Necessity (LMN) from your doctor or a documented prescription. The letter typically states the medical condition, why massage therapy is recommended, and the frequency or duration of treatment. Your plan administrator may have a specific form they prefer.
Do you accept HSA and FSA cards directly?
Yes. Most HSA and FSA debit cards process the same as a regular credit card at our front desk. If your card is declined for any reason, we accept any other form of payment and provide an itemized receipt you can submit for reimbursement.
What if my card is declined?
Cards can be declined for a variety of reasons — merchant category, card balance, or plan-specific limits. If yours is declined, pay with another method and we'll give you an itemized receipt. Submit it to your plan administrator with your Letter of Medical Necessity for reimbursement.
What goes on the receipt?
Our standard receipts include the date, service performed, duration, amount paid, our business name and address, and a transaction ID. If your administrator needs additional fields — diagnosis code, provider license number, NPI — let us know and we will provide what we can.
Are facials, waxing, or memberships eligible?
Almost never. Facials, waxing, and general spa memberships are not considered medical care under IRS rules and are not eligible for HSA or FSA payment.
How do I submit for reimbursement if I paid out of pocket?
Log in to your HSA or FSA portal, look for "submit a claim" or "reimbursement," and upload your itemized receipt and your Letter of Medical Necessity. Most plans process claims within a couple of weeks.
Will my insurance cover massage therapy?
Most standard health insurance plans do not cover relaxation massage. Some PPO plans cover medically-necessary massage when delivered by a licensed therapist with a referral. We do not bill insurance directly, but we can provide the documentation you need to file your own claim.
Can I use HSA/FSA for prenatal or post-surgery lymphatic massage?
These are some of the most commonly approved uses of HSA and FSA funds for massage. Prenatal massage during pregnancy and lymphatic drainage after surgery are typically well-documented as medically beneficial. Confirm with your plan and have an LMN ready.

Ready to book?

Choose your service, bring your card and your LMN, and we'll handle the rest.