www.thebodyworker.com

One of the main things that I see massage therapists doing is undervaluing and underpricing their massage sessions.

While we want massage to be affordable to many - what is affordable? What are people willing to pay for their health and the service of massage?

It also depends on what you need to be able to make a nice living - so that you aren’t constantly struggling to get by. Figuring out your cost per client and figuring out what you need to charge can help you get clearer about what you need charge. It is a business after all and you need to be able to run it on sound financial principles.

Everyone should charge something different based on their needs. The massage profession also tends to attract people who don’t have many “need” or wants. While this may seem noble and all serving, it also creates an image that seems to say - we aren’t deserving.

There is such a fine line between wanting things for material purposes and wanting things because they will bring joy or peace to your life.

What we do is more powerful than what any doctor does. We spend so much more time with people exploring their health issues with them. What should we be paid for that? What is that worth?

How can we best serve people? Mainly by taking care of ourselves and having the money we need to do that.

Mikeann Valterra talks about noble poverty and other issues that we are faced with in her book “Why Women Earn Less“. I think it could be called “Why massage therapists earn less” The book really hit home in so many ways and I see the issues so prevalent in the massage profession.

In it she says:

“Underearning happens when you repeatedly (and consistently) make less than you need or than would be helpful to you , usually despite your desire to make more money. Put another way, An underearner is someone who doesn’t get paid as much as might be expected, given her experience, education and training.”

Some of the common “excuses” massage therapist use for not making the money they need are things like:

• it isn’t about the money — It is about the money. You need to make money to live comfortably and save for retirement. You deserve it. Money is what it takes to help relieve poverty, hunger and other social issues are world is faced with
• I don’t need much. –There is a fine line between not having needs and not feeling self confident enough to ask for what you need. Not needing much, people think that they are “noble” and think that to have money it is somehow wrong.
• Not being able to ask for what one needs is what I call “The code of the caretaker” - We do for others what we wish that they would do for us. It shows up in a massage practice in various ways. One of them is undercharging for our services. Thinking things like “who would pay so much for me to work on them” is loaded with inner beliefs that just aren’t true.

The other thing is the fact that there are people in poverty that could use massage and it is just not affordable. Places like Massage Envy are making it possible for everyone to get a massage. (Although I think there is a whole other side to companies like this in the way they treat massage therapists by only paying them $15 per hour. Who can live on that?

Feeling like you have to underprice your services to be available to such populations is a personal choice. When you have to work for less, you have to work more hours to pay the bills. As a massage therapist, the number of hours that you can do massage in one week are limited first by the number of hours and then your physical and emotional strength to do massage. The length of one’s career is greatly affected by how much you undercharge for your services even in the beginning. If you are having to work long hours the fact is that it does take it’s toll on you.

(I for one am the shining example. I have been doing massage for 17 years and I took over a practice where the guy was only charging like $25 per massage. I felt like I couldn’t raise it too much to start with or I would lose all his clients and prospects. So I worked more. After 17 years I can say I should have charged more in the beginning. One of the reasons why I started my website projects was because I was burned out! I couldn’t physically or mentally take dealing with clients and my health started suffering. While part is due to just plain aging - most of it is because I neglected to charge what I needed to live. I was always struggling to get by and always giving too much to others thinking it would get me more in some way. What it got me was burned out.)

So what is a realistic amount for massage therapists to charge for their services.

Charge what you need to make so that you don’t feel resentful about the work was the advice of Mikelann Valterra. I totally agree. I have been working for some insurance companies who pay me less than my $75 per hour fee and I am starting to feel resentful. I am hoping to move away from taking insurance and get back to my cash practice.

What do you need to charge?

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I am working on creating an accurate profile and job description for massage therapists…
Personal Profile

• comes to the profession looking for more meaningful work
• can be found saying that they are not in this for the money
• can often be found giving more to others thinking that it will help more
• often no financial backing to start a business
• usually needs to work another job at least to start
• works for low wages or under prices their massage sessions for the sake of trying to get another client
• very little business experience or marketing knowledge

Job Description

• work with clients who are injured, stressed out, or faced with serious illness.
• has a thorough understanding of anatomy and physiology
• works with the client to create and implement a treatment plan including stretches, home care, stress reducing techniques and lifestyle changes
• business manager : taking care of account receivable and accounts payable, taxes, budgets
• marketing manager: creates and implements marketing plans to build business
• deals with client retention
• understands high quality customer service
• record keeping: write chart notes, progress reports, narrative reports and appear in court if necessary
• obtains medical history from a thorough intake process
• Able to maintain clear boundaries
• able to actively listen to a clients needs without imposing advice or the therapists own needs into the session
• educates clients on how the musculo-skeletal system works and reacts to stress and trauma
• maintains client confidentiality at all times
• explains procedures and policies so that the client can make an informed decision about their massage
• engages the client in the process of healing.
• must be able to handle the physical demand of the job
• be knowledgeable of medical conditions and the implications of massage (contraindications and indications)

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If you are going to be billing insurance companies next year you will need a National Provider Number.

Vivian Madison Mahoney outlines the process in this article for Massage today.

You will also need to start using a new billing form called the CMS 1500 for most billing by March of 2007.

I haven’t taken a look at it yet and am hoping I won’t have to as I am planning on getting out of doing insurance work soon!

More info on NPI numbers

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One of the first steps in building a practice involves getting clear about what you desire.

In “The Science of Geting Rich” (the free ebook offered by Rebecca Fine and available through her website -www.scienceofgettingrich.net) was originally written by Wallace Wattles the 1910 author who was way ahead of his time calls it creating a ‘clear mental image’. He says:

“You must know what you want and be specific and definite. You can never get rich or start the creative power into action by sending our uniformed longings and vague desires”

Creating your vision of your Ideal massage practice (or job) will help you get clear about what it is that you want so that you can figure out what steps you want to take in getting it. It is kinda the same as cooking dinner. You start with what you want to cook and then work backwards - you know what you want to make, you get the ingredients and you read the recipe and put them all together and soon you have dinner.

Without having a clear focus of where you are going, you won’t be able to get there.

Who is your ideal client?

What do they value? They value their health enough that they are willing to do whatever it takes to help them feel better.

I have some more information on my website on creating a vision for your practice.

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In 2005 I wrote the latest addition of the Insurance Billing Manual.

After some thought about what I want to be doing with this blog and my websites, I have decided to put all of the manual online for free for some various reasons:

• I am phasing insurance billing out of my practice because I no longer want to be a slave to insurance companies who are deciding our future. They are making steps to define medical massage by requiring special training above and beyond what is required for State Licensing. Our profession just sits and takes it.
• Here in WA as a contracted provider for HMO’s and PPO’s like Regence Blue Shield and Premera Blue Cross, I am paid less than my going rates and they are constantly reducing their allowable fees again because they can and no one is standing up to them with any success.
• One of the reasons things like this are happening is because massage therapists do not understand the severity of the issue. People in other states go where they are only allowed to bill for MVA’s or L&I are being paid fair amounts (and in my opinion -too much) for their services. Massage therapists are continually seeking to be accepted by such companies because they think it will be an easy way to get clients - it may help get clients but at what expense???
• It also has become more difficult to work with people who are on insurance as they don’t really understand that it is not for their stressful lives that causes the muscle tension and pain. They think the insurance companies should be responsible, but in reality it is the client who should be taking more responsibility. (This does not include people who are really hurt or injured)
• Insurance companies require that we “fix” clients and be able to prove it which really is not about healing in my opinion. Sure injuries have to repair themselves but what is the meaning of healing?
• Insurance companies are reducing their allowable fees, reducing benefits and delaying payments.
• Insurance companies do not take into account the power of the therapeutic relationship. They are attempting to eliminate so called “relaxation” massage and other types of massage that does not directly influence the injury or problem. This will eliminate many types of touch that are healing from being covered.
• Have you tried to find a good doctor lately? Most are opting out and taking cash only. They long ago got sick of having to spend so much just to keep a patient. It is happenind for Physical therapists and others too
• Personally, I do not want to be a part of such a system and hope to be instrumental in teaching massage therapists about what they are getting into when they want to accept insurance.

So for these reasons, I am making the insurance billing manual available so everyone can learn how to bill and experience it first hand so they can decide for themselves.
personally feel that the cost of playing with these insurance companies far outweighs the cost of getting new cash clients and teaching clients how to accept more responsibility for their health.

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