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Treatments & services

Is massage therapy FSA eligible?

Eligible with a letter of medical necessity

Sometimes — massage is FSA eligible only with a letter of medical necessity for a specific condition.

A relaxation massage doesn't qualify. Massage prescribed to treat a specific condition — chronic back pain, injury rehabilitation — can qualify if your doctor writes a letter of medical necessity stating the condition and treatment. Get the letter before you spend.

Before you buy: get the letter first

  • Ask your doctor for a letter of medical necessity that names the condition and why this is treatment, and keep it on file.
  • Then pay with your FSA/HSA card or file a claim with the letter attached. Buying before you have the letter risks a denied claim.

Does the same answer apply to an HSA?

Yes. FSAs and HSAs share the same qualified-medical-expense rules (IRS Publication 502), so eligibility is identical. The difference is the deadline: FSA money is forfeited at the end of the plan year, while HSA money never expires.

Last reviewed 2026-06-11. Based on IRS Publication 502 and published IRS guidance. Not tax or medical advice — your plan administrator has the final say.

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