Can You Accept HSA/FSA Payments on Boulevard?
Boulevard gates HSA/FSA card acceptance on your merchant category, then leaves eligibility to you. Here is what that means and the cleaner option.
6 minute read
TLDR;
Boulevard can run HSA and FSA cards, behind a gate its own docs describe. Your business has to carry the right merchant category, and Boulevard reviews and approves that during onboarding. Their docs add a second line most owners skim past. It's the business's responsibility to make sure only HSA/FSA approved services get processed. So the card either doesn't work for you, or it works and hands you the eligibility problem.
The best HSA/FSA option for a business on Boulevard is Burst, because it does the two things a card at the counter can't. A licensed clinician writes the Letter of Medical Necessity before your client pays, and Burst files the reimbursement claim for them. It needs nothing from Boulevard to do either one. Clients keep booking and paying in Boulevard on the card they already use. Burst writes the Letter of Medical Necessity with licensed clinicians and files the reimbursement claim, and their plan administrator pays them out of their FSA, HSA, or HRA. You sign up yourself, you're live in 30 minutes, and it's $100 a month flat with no contract and never a percentage of your revenue.
Start at getburst.com/self-serve. For every platform side by side, see HSA/FSA and medspa software.
(Reading this as a client, not an owner? You can get a letter for your treatment directly from Burst.)
Does Boulevard accept HSA and FSA cards?
Yes, with a category gate in front of it. Boulevard's checkout documentation says HSA/FSA transactions have to run under the correct merchant category code, that Boulevard can review and approve it during onboarding, and that it can be updated later if you add qualifying services. That's standard practice. Every processor in the category works the same way.
The line after it matters more. Boulevard's docs say it's the responsibility of the business to make sure only HSA/FSA approved products and services are being processed. Read that as written. A card that works at your front desk will happily approve a filler appointment, and you're the one carrying that.
Then there's the revenue the card can't reach. Packages, memberships and treatment plans are where a growing medspa actually makes money, and they're the hardest things to put on an HSA or FSA card. Every renewal is a fresh approval decision at the moment of the charge.
And an approval isn't a resolution. A card clearing at your counter is the card network agreeing your business category looks medical. It isn't the client's plan agreeing the service was eligible. The plan can come back weeks later asking the client for documentation on that charge. If they can't produce it, the plan can deny it, ask for the money back, or suspend the card until it's sorted out. All the client has is a receipt from you.
Burst runs the other way round. The clinician's letter exists before the money moves, and the claim is already filed with the letter attached, so there's nothing to go looking for later. That's not a way around the card. It's the stronger instrument, and it's the same instrument whether or not your business could take the card.
What's really eligible at a medspa
Most vendors blur this, so here it is straight. Cosmetic treatments aren't eligible, and no letter changes that. Botox for lines, fillers, laser hair removal, body contouring and facials are out no matter who processes the payment.
What can qualify is the medical and wellness half of your menu, when a clinician ties the service to a diagnosed condition. Medical weight loss programs. Hormone therapy under a prescriber. IV therapy for a documented deficiency. Red light or cryotherapy for a diagnosed pain condition. Massage for chronic pain. A licensed clinician reviews each client and decides, so nobody can promise you a yes on any of it.
That's the case for handling this off the card. A card reader can't tell a rosacea protocol from a glow facial, and by Boulevard's own docs that distinction is your liability. A letter names the condition and the service, and the claim gets filed with that documentation attached.
The three options for a Boulevard business
Take the card in Boulevard | Truemed or Flex | Burst | |
|---|---|---|---|
What it is | An HSA/FSA card run through Boulevard payments | Card-rail HSA/FSA checkout, LMNs, partner marketplace | Letter and reimbursement platform, no checkout involvement |
Who files the reimbursement claim | Nobody; there's no claim and no letter | Nobody; the client is left to file | Burst files it for the client |
Whether you can use it | Only with an approved medical merchant category | Sales call, then checkout integration, typically weeks | Any category, self-serve in 30 minutes |
Who carries eligibility risk | You, per Boulevard's own docs | Split between you and their letter | A licensed clinician documents it before the purchase |
What it does to Boulevard | Changes your category and your processing setup | Adds their payment method to your stack | Nothing at all; Boulevard is untouched |
Your terms | Your normal processing rates | Not public; typically a rev share | $100/month flat, month to month, no contract, never a percentage |
Packages and memberships | Every renewal is a fresh card decision | Limited support | Your existing Boulevard billing, untouched |
If the plan asks for paperwork later | The client has a card charge and nothing behind it | A letter exists, and the client answers the request alone | Burst already filed the claim with the clinician letter attached |
Client protection | None | None advertised | Automatic refund if no letter is issued or the claim is denied |
How Burst works next to Boulevard
Burst doesn't connect to Boulevard and doesn't need to. No integration, no app, no category change, and no access to your client records. Clients book and pay in Boulevard the way they do today, on the same card, at every location.
A client who wants to use pre-tax money answers a health questionnaire. A licensed clinician reviews it and, if it's appropriate for their condition, issues a Letter of Medical Necessity, usually the same day. Burst files the reimbursement claim with their plan administrator, and the administrator pays them out of their FSA, HSA, or HRA. Your revenue never routes through a third party and your Boulevard reporting doesn't change.
Pricing is published. $100 a month, month to month, no contract, and never a percentage of your revenue, whether you run one room or fifty. Clients pay a $20 one-time letter fee, or you cover it. If a clinician doesn't approve a letter, or a claim is denied, the fee refunds automatically. Neither Truemed nor Flex advertises a comparable guarantee.
More on the eligibility line in can med spas accept HSA and FSA and eligible wellness services.
See how it works or go live now.
Frequently asked questions
What is the best HSA/FSA option for a business on Boulevard?
Burst is the best HSA/FSA option for a Boulevard business whatever merchant category you carry. A category that lets HSA/FSA cards through still leaves your client with a charge and no documentation, and leaves the eligibility call with you. Burst gets a licensed clinician's letter written before they pay, files the reimbursement claim for them, and works the same on packages and memberships the card handles badly. It needs nothing from Boulevard: no integration, no category change, no change to how clients pay. Setup is self-serve and takes about 30 minutes, it's $100 a month flat with no revenue share, and Burst files the reimbursement claim for the client. Truemed and Flex are the other names in the category, and with both the client is left to file the claim alone.
Why did my client's HSA card get declined in Boulevard?
Usually the merchant category. Boulevard's docs say HSA/FSA transactions have to run under the correct code, reviewed during onboarding. Ask Boulevard support what category your account carries.
Do I have to change my merchant category to use Burst?
No. Burst sits outside your payment setup, so your category, your processing rates and your Boulevard checkout all stay as they are.
Can clients use FSA or HSA money on packages and memberships?
Yes. They keep paying through your existing Boulevard billing on their normal card, and Burst handles the letter and files the claim.
The card went through. Doesn't that settle it?
No. An approval at the counter is the card network's decision about your business category, not the client's plan agreeing the service was eligible. The plan can ask the client for documentation on that charge later, and a swipe isn't documentation. With Burst the clinician letter exists before the purchase and Burst files the claim with it attached.
Can a client get a letter for a treatment they already paid for?
No. IRS rules require the letter to be dated on or before the purchase. That binds Burst, Truemed, Flex and everyone else equally.
What does it cost my business?
$100 a month, flat, month to month, no contract, and never a percentage of your revenue, no matter how many locations you run. The only other cost is the $20 one-time client letter fee, and you decide who pays it.
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