What is relaxation massage? What is Medical Massage? How is relaxation massage different from medical massage?
These questions are need to be answered by the massage profession now, because if we don’t start stepping up and defining ourselves – the insurance companies and individual state licensing acts will and are.
One of the reasons why this needs to be defined is that massage therapists are actually billing insurance companies and charging them more than their cash rates rationalizing by saying that what they are doing is medical massage. Since there is no definition of medical massage that reasoning will not mean anything in a court of law.
The thing about relaxation massage – is any massage ever really only a ‘relaxation’ massage? If you are doing a relaxation massage what do you do when you find a tight muscle or a triggerpoint? What do you do if the person says they have stiff neck from sitting at the computer all day? In 18 years of doing massage, I don’t think I ever did just a ‘relaxation’ massage. Do people at spas or resorts just do relaxation massage?
One of the things that the so called ‘medical massage’ group is trying to do is to separate what they do from someone who they are judging to be less qualified. Education and more hours of training does not necessarily make one more qualified although most of our society gets caught up in thinking so.
So called ‘relaxation’ massage does have it’s place in medical massage since most medical conditions can in one way or another be linked to stress. Eliminating relaxation massage from the medical equation would be a great disadvantage to the profession. We need more research to prove that there is a difference -if any- between relaxation massage and medical massage.
Relaxation massage as far as I understand is also basic Swedish massage. When you learn the benefits of Swedish massage the main things talk about the medical benefits – reduces blood pressure, increases circulation. increases range of motion,
What therapies would be included as being medical massage? What therapies would be excluded? Is medical massage just the ability to work with a physician and an insurance company?
In order to be paid by an insurance company one needs to be able to show improvement in a condition and be able to write medical chart notes that prove medical necessity. The sessions must show that they have outcomes in mind when doing the session. Anyone can learn to write chart notes that way. Hands Heal is a great book that will teach you all you need to know and more.
Other reading : www.thebodyworker.com
Medcial Massage - Marriage or Monster – by Deane Juhan Massage and Bodywork
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I find, in this area, that many massage therapist request a different amount between swedish vs deep tissue. Although I understand the concept of using more energy and “tiring” self when doing deep tissue vs a lighter massage, I’ve tried to get a clear answer from MT’s as to when they decide their pressure goes from being worth one amount to another. I’ve posed the question, also, if the depth of pressure is up to them or the client and have attempted to clarify how this could be confusing for clients since there’s no pressure scale from one MT to another – My deepest pressure might not be as deep as yours but rather comparable to what you consider a “light, Swedish” massage (I’m exaggerating a bit, but attempting to put the idea across).
I could go on but then I’d end up writing an entire post within your comments sections.
In the state of PA, the only insurance that covers massage is ones for auto accidents and workman’s comp; and, then it’s only with a doctor’s referral.
Actually there is very little harm done in a massage ever. That is why liability insurance is so low.
Here in WA State where we are contracted providers with companies like Premera Blue Cross and Regence Blue Shield you can use any type of massage as long as you show improvement in a clients condition. None of the definitions really matter.
Julie
I’m gonna answer your question.
My answer was found on this website of which I visit often:
http://www.massagetoday.com/aboutmt/
1)Swedish Massage – Generally regarded as the most common form of massage, Swedish massage involves a combination of five basic strokes and concentrates on the muscles and connective tissues of the body for improved circulation, relaxation, pain relief, and overall health maintenance and well-being. Swedish massage is also one of the less demanding techniques for massage therapists to practice as it usually does not involve deep-tissue work.
2) Medical Massage – Practitioners of medical massage have a strong background in pathology, disease, illness and injury, and the contraindications of specific massage techniques related to various medical conditions. Medical massage therapists frequently work under the direction of or at the request of physicians.
3) Orthopedic massage – combines several massage and medical massage techniques to treat pain and soft-tissue injury. It focuses heavily on injury assessment and rehabilitation, emphasizing the importance of selecting the appropriate modality to treat the injury. Orthopedic massage is often used in conjuction with sports massage protocols.
As you can see there is a marked difference between them all. You NEVER do anything deep in a relaxation massage. And medical work if to help treat, heal, or help people to cope with conditions such as cancer. Now, the orthopedic work is for those who have had auto accidents and worker’s comp cases. That’s because you work more to help relieve joints, neck/back issues, and ligaments and muscle strains/sprains. Sad to say too many MT’s are not staying in thier scope of practice and charge Ins companies for relaxation work; and well, they shouldn’t. To be either a medical or orthopedic MT, you have to go thru further training.
Now as far as the Ins companies are concerned. It is sad also that MT’s don’t set a standard for charges.
1) first the MT needs to find what scope of massage best suits them as a person. (ex. energy work, sports, medical, orthopedic, pre-natal, spa..etc.)
2) then decide how far you want to journey into that.
3) get schooling!!! never never never work with out certification. People get hurt.
4) stick to that! Try not to “blend” what you know. You can’t give a back scrub and pass that off as medical because a person has back problems and you want to give them thelossatherapy. Ins won’t pay. Plus that sounds stupid, anyway…LOL!
5) And once you decide what to do, make a price chart and stick with it. You only raise your price when the economy raises it’s worth. And your pricing should be equal to all.
(ex. I charge %75 for an hour and 15 mins. but $2 a minute after that and for deep work – orthopedic massage). This pricing I use is the same for my clients, patients and ins companies. I do not cheat. And I’ve already been in court over it, and I know it’s ok.
As far as being a provider, or such, I don’t see how that matters. You still have to deal with the Ins companies. And from what I’ve worked with they either pay you as you treat (i.e. – auto ins.) or as a lump sum (at the end of all the treatments). And that’s whether you’re in network or just treating a person from a carwreck.
Thanks for reading this far. Take care! ^_^
<333
Reply to comments:
Feeling justified in charging more does not really matter. You can not charge more for paperwork and phone calls. It is considered a part of doing business.
The issue really is can you prove this in a court of law if and when you are challenged by an insurance company.
Focusing on building a cash practice is a big part of the solution.
While we once had out of network benefits for many insurance companies, they are now eliminating those benefits or making it impossible to collect. I for one have a $2000 deductible on my out of network benefits and that is separate for my regular deductible and the number of sessions of treatment are being reduced to make it a number below that deductible anyways. There also is one company here that has a few out of network benefit policies and if you charge the UCR for Seattle which is about $132 you would get paid more for out of network than you would if you were a provider in network which really does not make any sense.
Thanks for participating!!
Julie
Hi all!
I wanted to post a comment regarding insurance billing. I am a certified medical coder with years of experience in insurance billing. I am currently enrolled in a massage therapy program. I am new to the profession but I am not new to the insurance world. I have seen it grow to a great concern for the entire medical community! All insurance companies have gone to medicare reimbursement guidelines or a little bit higher. It was no surprise to read the previous post about the Chiropractor selling his practice. They cannot live on what insurance companies pay them. But in order to build a practice think that the need to participate with insurance companies and sometimes in the medical world this is true but not always!
That is the key I believe that a massage therapist should never participate with a insurance company. A client can go out of network and recevie out of network benefits. They will have to pay more out of pocket, but if they value you as a therapist they will still come to you. I know of several Dentists that have gone to a fee for service practice due to insurance companies lack of payment and I strongly believe massage therapist should do the same. Everyone just needs to be educated regarding the pro’s and con’s of insurance billing.
Just thought I would offer some of thoughts.
Liz Larson, Massage Therapy Student and Certified Medical Coder
The downside of working with insurance companies in California.
I just ran into a chiropractor friend who I had not seen in a while. He is about 5 years out of school and is selling the practice he bought about 3 years ago and going back to work for his father’s construction business. He said that ” insurance is killing me and the patients are killing me.” It’s really sad that this is the end of the line for him and he may barely pay off his loans from school by selling his practice.
I shudder to think of the future of “medical massage” where we will be forced to take what the insurance company gives us and try to make a living. It’s nice to be unlicensed at this time and be able to pick and choose patients- not be forced to.
I work with many cases that are referred by PTs and MDs. I will give the client a receipt, HCFA or whatever they need. Yes, it takes some more time and it empowers the cllient to take care of their own health care needs. My rates are a little higher than most in my area but not by more than $5-10. After almost 19 years in the biz, I feel like I’m doing the best I can and able to earn a living.
As far as “medical vs. relaxtion massage” goes- I won’t use the term “medical massage,” even after taking several classes from one of the big proponents. This is going to split the profession and divide therapists so that the industry can make $ teaching classes, giving certifications, etc. When I had over 40% of my practice billing insurance, I noticed two things.
1. No adjustor ever asked if I was certified in “medical massage.”
2. I had to work one and one-half times as hard to collect fees from an insurance company versus a cash patient.
I don’t want to see MTs going broke like my chiro friend because someone says insurance billing is the future. BS. Just ask any PT, DC, or MD about their experience. They wish they could have a cash practice.
My 2 cents,
Jody Hutchinson, NCTMB
free range massage therapist
I’d like to comment on your statement of massage therapists charging insurance companies more that their cash clients. For one thing, only Aetna ever pays more than our cash clients do. All of the other insurance companies we are contracted with pay us less than cash clients no matter what we bill them. There are several reasons behind why they are billed at a higher rate. One of them is that you have to take the time to fill out the hcfa form, send soap charts, progress reports, etc… There is a bit more work and time involved in insurance claims. Another reason is that you have to wait anywhere between 6-8 weeks to even see your money from a massage that long ago. So, I completely feel justified that insurance companies are charged more than cash clients as there is alot more work involved.
Lisa