Letter of Medical Necessity for Massage: How to Use Your HSA or FSA
Many ARC Members pay for their sessions with pre-tax HSA or FSA funds. The key is a Letter of Medical Necessity (LMN). Here’s what it is, what it needs to say, who can write one, and how to get reimbursed, plus a free template you can hand to your provider.
What Is a Letter of Medical Necessity?
A Letter of Medical Necessity is a short note from a licensed provider that documents a specific health condition and recommends a service, like massage or recovery sessions, as part of addressing it. HSA and FSA administrators use it to decide whether an expense is an eligible medical expense under IRS Publication 502.
Is Massage HSA or FSA Eligible?
Massage can count as an eligible medical expense when a licensed provider documents that it’s recommended for a specific health condition. General wellness or relaxation on its own doesn’t qualify. Your plan administrator makes the final call, so check your plan’s rules.
What Goes in an LMN for Massage
- Your name and date of birth
- The provider’s name, credentials, contact details and signature
- The health condition being addressed
- The recommended service (for example, “robotic massage recovery sessions”)
- How often and for how long (for example, 2 sessions a week for 12 months)
- The date of the letter
Who Can Write One: 3 Ways to Get Your Letter
- Your own provider: your primary care doctor, physical therapist, chiropractor or any licensed clinician you already see.
- Telehealth: many online services can issue an LMN after a short visit.
- At INA Spa (River North): INA’s providers can complete a consultation and write your note, and we’ll book it for you.
Free LMN Template for Massage
Our ready-to-use template lists everything above, so your provider only fills in the details and signs.
Your template is ready. We’ve also emailed it to you.
How to Get Reimbursed, Step by Step
Get your Letter of Medical Necessity.
Book and pay for your ARC sessions as usual. You don’t have to pay with your HSA/FSA card.
Request your itemized invoice from ARC (each session, date and amount).
Submit the invoice and your LMN to your HSA/FSA administrator, by card payment or reimbursement claim.
Keep copies for your records; the IRS recommends keeping tax documents for at least 3 years.
See What Your Sessions Cost With HSA or FSA
Use the HSA/FSA calculator to see your plan and your real cost per session. Ready to start? Book at your location.
Letter of Medical Necessity FAQ
Both can reimburse eligible sessions. FSAs usually want the LMN on file before you claim; with an HSA you self-substantiate, but keep the LMN in case of an audit.
Usually not. Massage for general wellness isn’t an eligible expense; the LMN documents why it’s recommended for you.
Your provider decides. It must be a specific condition, not general wellness.
Your provider sets the time frame, and many plans ask for a new letter each year. Check with your administrator.
Often yes, if the sessions fall within your plan year and the period your letter covers. Check your plan’s deadlines.
No. Pay any way you like and reimburse yourself later with your invoice and LMN.
HSA and FSA funds can generally cover eligible expenses for your spouse and dependents. Each person needs their own LMN.
Yes. Ask us and we’ll email one that lists each session, date and amount paid.
ARC Recovery provides this guide for convenience only and is not a tax, legal, or medical advisor. Eligibility and reimbursement are determined by your plan administrator and the IRS. Please confirm details with your administrator or a tax professional.