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Massage Today
July, 2003, Vol. 03, Issue 07

We Get Letters & E-Mail

By Editorial Staff

Editor's Note: Some letters have been edited for space and clarity.

Controversy Over Fees

I would like to thank Alice Belusko for her letter to Massage Today (March 2003, in reference to my article, "Fees" (October 2002,

In response to Alice's statement, "I'm not sure if [Vivian] has personally done 25 hours of massage, week in and week out, for any substantial period of time.

If she possessed this type of experience, I'm sure her article would have defended the billing fees of LMTs": In my defense, I did not begin to perform massage therapy until I was 45 years old. I worked seven days a week, every week, on seven to eight patients a day. I worked this way for over a year from 8 a.m. until sometimes as late as midnight, often going home in tears with sheer exhaustion. I charged $25-$40 per massage, each being one hour or more, mostly deep-tissue. I opened my own office after a year.

During this time, many of these clients became medical and insurance-related cases. Alice misquoted or misunderstood me in her letter by saying I had charged $95 per massage in 1984-85. I first charged $35 to $40 until I began the prescribed therapy. I then raised the medical-case fees to $56 for years, until I got the nerve to raise prescribed fees to $65. I finally raised the basic rate to $75 in late 1997 for hands-on services, and added $20 for a modality if prescribed (whether or not it was for one or four modalities).

I also served for nine years as the insurance committee chair for the Florida State Massage Therapy Association (FSMTA). We worked very hard to get laws passed that required insurance companies to reimburse massage therapists for massage when prescribed by physicians. We were successful partly because we showed that we provided the same services as other providers, but at a savings to insurers. At the time, workers' compensation was paying a maximum of $58.50 per treatment, which was my average, since most of my cases were from workers' compensation. Now, worker's comp payments average about $96.

Why did I have a successful business? Because I built a reputation providing quality services at reasonable prices people and insurance companies could afford.

Florida law states in essence, "If a policy covers massage then it shall cover the services of one licensed to perform massage."

Make no mistake. All the insurance companies have to do is write massage out of the policies, and WE ARE DONE! Insurers are looking to save money. If we provide the best for less - I didn't say for nothing, only less - then, we will be searched out, not written out.

P.S. At age 63, I still carry my table and give as good a massage as anyone. The client or insurers will still get what they pay for even though I do not charge upwards of $150 or more for the therapy. Luckily, I was able to retire on the measly low rates I charged, so now I do not have to do that. I sincerely wish that for all of you!

Vivian Madison-Mahoney
Gatlinburg, Tennessee

Dear Editor,

I just had to respond to the ludicrous letter from Alice Belusko. I do not dispute the title "My hands are just as important as a surgeon's hands," but all goes downhill from there; the rest of the letter is basically bereft of reasoning.

To the whine: "Do you know how many years the therapist can work? When was the last time you saw a 60-year-old massage therapist dragging his or her table through someone's front door?" I am almost 60 years old, and I can still perform this "heroic" work. I had the basic common sense to purchase a light weight table and a carrying case, so I can actually carry, rather than drag the table. Why would someone who has 25 hours of massage every week, year after year, avoid the common sense to rent an office and avoid all this pathetic dragging?

I agree with Vivian that billing $145 to $175 an hour is excessive. I bill according to Medicare limits, all of my fees, whether private insurance or Medicare. The amount allowed in this area for manual treatment is $25.34 for a 15-minute increment. An hour would be $101.36. This is what anyone would get for this treatment, including occupational or physical therapists who have much lengthier education requirements.

If it's worth it to you, pay it out of your pocket, but spare the rest of us the rapidly accelerating insurance rates by gouging insurance companies and giving responsible LMTs a bad rep.

Bonnie Clancy
Sanibel, FL

Dear Editor,

I am writing in response to Vivian Madison-Mahoney's article, "Fees" (October 2002). With all due respect for Vivian's areas of knowledge and expertise, I feel that the massage practitioners who have invested in specialized training, and have committed to doing the work that results in the resolution of repetitive strain injuries; whiplash; frozen shoulder; failed back surgeries, etc., are well able to command rates other than those commanded by massage therapists with "minimal training." These techniques produce real results.

It's a big world out there, and while traditional forms of bodywork certainly have their place in the scheme of things, perhaps a broadening of perspective would refresh not only Ms. Madison-Mahoney's frame of reference, but also acquaint her with new vistas of paradigm in our wonderful profession - ones that the medical profession are only now beginning to turn to.

The average case of carpal tunnel syndrome costs around $100,000 between lost productivity, worker's compensation and medical costs. A few treatments with a massage therapist highly skilled in the techniques which resolve soft-tissue dysfunction and syndromes (which end in "itis") is a sure bargain.

C. Carow, NCLMT
Las Vegas, Nevada

"A Fully Trained Massage Therapist is a Medical Professional"

Dear Editor,

This is a commentary to Vivian Madison-Mahoney's view on the "Medical Massage Controversy" (April 2003,

I am not really sure when "massage" became nonmedical and started to be linked to pleasure, mischief and more. It is not accidental that a massage therapist is called a therapist - a therapist being a medical professional, according to my terminology.

In my opinion, a fully trained massage therapist is a medical professional. I would like someone to explain the difference between a regular massage and a medical massage. If I visit my massage therapist, I will tell him/her where it hurts, which area to concentrate on and which ones to avoid; he or she will do their best to comply. I am usually relieved of pain (if sometimes only temporarily) and feel de-stressed and relaxed - an added benefit.

This I do, because I would rather eliminate aches and pains the natural way than to pop any kind of pain medication, even if it is "only an aspirin or Tylenol", or similar. For those kinds of ailments, I do not need a doctor's prescription, but would recommend that insurance companies provide reimbursement for visits to a massage therapist just as they would for visits to any medical professional; this, along with other complementary medical modalities, should be addressed by the insurance companies, as they will be saving money in the long run by investing in preventative and natural health care from the start. If we would all ban together to make this happen, then we would make progress in all of our fields.

I wholeheartedly agree with Ms. Madison-Mahoney that schools should devote much more time to the medical side of how massage can relieve a number of conditions, and when to refer a client to a doctor; agreed that many years of experience will give a massage therapist more confidence and expanded knowledge, but the base education should be more solid than what is being taught in massage schools today. If like in the medical profession, the massage profession could implement various degrees of LMT to assure clients of the courses and CEDs a therapist has studied and earned, or the specialty of an individual therapist, this would elevate the level of the massage profession and hopefully, one day, will eliminate associating the profession with escort services.


Hannelore R. Leavy
Executive Director
The Day Spa Association
The International Medical Spa Association


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