Flexible spending accounts (FSAs) cover massages for certain medical treatments. These treatments must be approved and prescribed by a physician.

The Internal Revenue Service (IRS) has ruled that massage therapy for the sole purpose of tension and stress relief does not qualify as an eligible expense. Examples of medical conditions for which your doctor might prescribe massage therapy could include back pain, arthritis, fibromyalgia, anxiety, depression, and pain management. 

How to Use an FSA for Massages

The first step to using your FSA to cover massage therapy expenses is to visit your doctor. Let the doctor know you have an FSA and are seeking massage therapy as the solution to a medically eligible condition. The physician will then write a prescription for your massage if they deem it to be medically necessary. The physician should provide three pieces of information on your prescription: why the massage is medically necessary; the number of sessions per month or frequency of your visits; and, the length of treatment. 

How FSAs Works

FSAs allow you to set aside pretax money to pay for qualifying medical and dental expenses, including copays and deductibles.  For 2021, employees can contribute $2,750 to their health FSAs, the same as 2020. 

FSA plans are only available with employer-based health care plans, and employers can also make contributions. One shortcoming of FSAs is the "use it or lose it" policy. Some plans may provide either rollover or grace period options, but most erase any money left in the account at the end of the year. 

The Bottom Line

If you suffer from a medically eligible condition that would benefit from massage therapy, you might be able to use your FSA to cover the expense.