Wondering if your medical aid covers massage therapy in 2025? Learn about BHF practice numbers, AHPCSA registration, and the rules for claiming from Discovery, Medihelp, and others.

With the rising cost of medical aid in South Africa, members are rightfully asking: “How can I get the most out of my benefits?”

We often associate medical aid claims with GPs, dentists, and hospitals. However, as the focus on preventative healthcare grows, many South Africans are surprised to learn that Therapeutic Massage Therapy is often a claimable benefit.

But before you book a massage session at your local spa, there are specific rules you need to follow. If you don’t check the fine print, your claim will likely be rejected.

Here is your complete guide to claiming massage therapy from medical aid in 2025.

Quick Checklist for Patients:

  1. Call your Medical Aid: Ask, “Does my plan cover Allied Health services like Therapeutic Massage from my Savings Account?”
  2. Ask the Therapist: Before you book, ask, “Are you registered with the AHPCSA and can you provide an invoice with ICD-10 codes?”
  3. Check Your Balance: Ensure you have day-to-day savings available.

The Golden Rule: No AHPCSA Registration, No Payment

The most important thing to understand is the difference between a Spa Therapist and a Therapeutic Massage Therapist.

Medical schemes in South Africa are governed by strict regulations. They are only authorised to pay for healthcare services provided by registered practitioners. In the world of massage, “registered” means the therapist is registered with the Allied Health Professions Council of South Africa (AHPCSA) and with the Board of Healthcare Funders (BHF).

  • Spa/Beauty Therapists: Focus on relaxation and aesthetics. They are generally not covered by medical aid.
  • Therapeutic Massage Therapists: Have undergone specific 2-year diploma training in anatomy, pathology, and clinical treatment. They are registered with the AHPCSA and BHF. These are covered by many medical aid plans.

The Bottom Line: If your therapist does not have an AHPCSA Registration Number and a BHF Practice Number, you cannot claim for your sessions with them.

What to Look For: Verified Qualifications and Practice Number

How Coverage Typically Works

Every medical scheme (Discovery, Bonitas, Momentum, Fedhealth, etc.) has different plans. However, most follow a similar structure regarding Allied Health services.

  1. The Medical Savings Account (MSA)

For the vast majority of members, massage therapy claims are paid from your Medical Savings Account. This is the portion of your monthly premium set aside for day-to-day expenses.

If you have a positive balance in your MSA, and you visit a registered therapist, the scheme will usually pay the claim immediately.

  1. Above Threshold Benefits

If you are on a Comprehensive or Executive plan, you may have an “Above Threshold Benefit” (ATB) that kicks in once your savings are depleted. Whether massage therapy is covered in the ATB depends entirely on your specific plan rules. Some schemes limit this benefit to GPs and Specialists, while others include Allied Health professionals.

  1. Prescribed Minimum Benefits (PMBs)

It is rare for massage therapy to be covered as a Prescribed Minimum Benefit (PMB). PMBs are usually reserved for life-threatening conditions or chronic disease management. However, if your massage therapy is part of a rehabilitation programme authorised by a specialist for a specific condition (like post-stroke recovery), it might be considered. Always ask your broker first.

What Your Invoice Must Include

To get your claim paid, the invoice you submit to your medical aid must be clinically accurate. A typed note saying “Back Massage – R500” will be rejected.

The Professional Standards Required for ClaimingMake sure your therapist provides an invoice with the following details:

  1. The Practice Number (BHF Number): This verifies they are a registered healthcare practice.
  2. The AHPCSA Registration Number: Proof of their legal standing to treat you.
  3. ICD-10 Codes: This is the international diagnostic code that tells the medical aid why you were treated. (e.g., M54.5 for Low Back Pain or M62.42 for Contracture of muscle, upper arm).
  4. The Procedure Code: The specific code for the treatment performed.

Which Medical Aids Cover Massage?

While MTASA cannot speak for every specific policy, the following major schemes generally provide reimbursement for AHPCSA-registered Therapeutic Massage Therapists, provided funds are available in your savings:

  • Medihelp Medical Scheme
  • Discovery Health Medical Scheme (plans with savings account)
  • Bankmed Medical Scheme (plans with savings account)
  • LA Health  (plans with savings account)
  • Quantum Medical Scheme (plans with savings account)
  • Remedi Medical Scheme (Comprehensive Plan)
  • Tsogo Medical Scheme (plans with savings account)
  • UKZN plan types with savings account
  •  

Note: Hospital plans and “Core” plans usually do not cover out-of-hospital therapies.

Don’t Waste Your Benefits

Therapeutic massage is not just a luxury; it is a vital tool for managing chronic pain, stress, and musculoskeletal injuries. If you are paying for medical aid, you are likely paying for access to this care—so make sure you use it.

Ready to book?

Ensure your therapist is legitimate. Click here to search the MTASA Member Directory to find a qualified, AHPCSA-registered Therapeutic Massage Therapist near you.

ARE YOU A THERAPIST? HERE IS YOUR “CLAIM-READY” CHECKLIST

To ensure your clients can claim successfully, your practice must have the following in place:

  • Active AHPCSA Registration: You must have your current year’s practice certificate and be in good standing.
  • BHF Practice Number: You must have an active Practice Code Number (PCNS) issued by the Board of Healthcare Funders.
  • Valid ICD-10 Codes: Your invoices must use the correct diagnostic codes (e.g., M54.5 for Low Back Pain) rather than generic descriptions.
  • Procedure/Tariff Codes: Ensure you are billing the correct tariff codes for your specific modality and time spent (e.g., consultation vs. treatment).
  • POPIA Compliance: A signed privacy policy that allows you to process your client’s medical and personal data lawfully.

Technical Pro-Tip: The “Golden Trio” of a Valid Invoice

If your clients are complaining about rejected claims, check your invoice for these three fields:

  1. Header: Your Practice Number and AHPCSA Number must be clearly visible.
  2. Patient Details: Your patient’s Medical Aid Details must be on the invoice or sent through to the medical aid with the invoice for processing. They must also have funds available in their Medical Aid Savings.
  3. Body: The ICD-10 Code (Diagnosis) must correspond to the area you treated, and the Procedure/Tariff Codes must be for Therapeutic Massage Therapy.