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Recently, Regence had clarified referral and prescription (RX) are two different documentation. You must have RX to get treated for massage. I hear this phrase all the time "my insurance don't need referral" but as stated they are two separate documents. Here's why... physicians or anyone can give a referral and refer you to a specific clinic. The referral does not need to have a diagnosis code because it is simply a referral. While prescription (RX), the physician is required to write a diagnosis code that will explicitly point out what and why you need to get massage treatment.