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2019 was a big year for massage therapy with many exciting advancements for the profession.

The Veterans Administration created a job description for massage therapists and started hiring massage therapists! It took them 15-20 years to make this happen. With the VA now recognizing massage therapists, more insurance carriers will start taking note too!

Medicare Advantage Plans started covering massage therapy but not as many as originally announced by AMTA who said 270 plans would cover massage. More plans will be adding massage therapy this year.

2019 Legislative Proposals regarding massage therapy and insurance coverage happened but none were passed to my knowledge:

2019 New Hampshire Bill proposal. HB 610-FN

2019: Virginia Bill Proposal: https://law.lis.virginia.gov/vacode/title38.2/chapter34/section38.2-3419/

2019: Oklahoma Bill Proposal: http://www.oklegislature.gov/BillInfo.aspx?Bill=HB+2652&session=1900&fbclid=IwAR3un4CZr0oHNWwloMCwbReEwCd6P0E31dqYx-svYRiO454GdI4l2N6qMrU

2019: Bill in Maine: http://www.mainelegislature.org/legis/bills/bills_129th/billtexts/HP025501.asp

2019: Bill in North Carolina. Bill Summary for S 544 (2019-2020) Bill: ESTABLISH NON-OPIOID TREATMENT ALTERNATIVES. (https://lrs.sog.unc.edu/bill/establish-non-opioid-treatment-alternatives)

Health and Human Services (HHS) The Comprehensive Addiction and Recovery Act of 2016 (CARA) required the Pain Management Best Practices Inter-Agency Task Force to develop the Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations – PDF*, which identified gaps or inconsistencies, and proposed updates to best practices and recommendations for pain management. This report includes calling for massage therapy. Unfortunately, they also did not include the correct research studies supporting massage therapy…but it is a start. (Where was AMTA/MTF/ABMP?)

For Me Personally, I was excited to accomplish my goal of getting my latest edition of the Massage Insurance Billing Manual completed and published into Paperback, Kindle and a PDF Download.

The Veterans Administration has recently announced their Qualification Standards for hiring massage therapists (Health Technicians) and created the GS (General Scale) pay scale for massage therapists.

This is big news for the massage profession. It has taken over 20 years for the VA to create a category in their system to allow massage therapists to be hired as massage therapists. So now massage therapists can be hired by the VA to work in their health clinics and be paid wages and benefits. While this is amazing in itself, it is the fact that the VA has created a job description along with educational standards that are required for the job… something that the massage profession has failed to do for itself in the US – EVER!

When other powers that be, start to define the profession for us – we lose control over our future. While the VA has done an excellent job with the language and requirements, this should have been done by the massage profession – namely the AMTA.

About the Jobs

Should you now be looking for jobs at the VA? Yes! Check the USAjobs.gov website. Search for Health technician, Massage therapist

How much can I make? Check the payscale for your city/area.

That payscale seems pretty low and a 40 hour work week would be too much for a massage therapist. This is just the beginning. VA/Government jobs also comes with health insurance, vacations, sick pay, and pensions!

About the Standards

You can read the full job description and standards on the VA Website – See the 5005/108 Staffing – Appendix G56 Health Technician (Massage Therapy) Qualification Standard or just download the PDF from here.

Here are the details:

COVERAGE. The following are requirements for appointment as a Health Technician (Massage Therapy) in the Veterans Health Administration (VHA). The requirements apply to all VHA Health Technicians (Massage Therapy) employed in the GS-0640 series. Massage Therapy is the practice of manual assessment and manipulation of the superficial soft tissues of skin, muscle, tendon, ligament, fascia, and the structures that lie within the superficial tissues. The Health Technician (Massage Therapy) occupation provides clinical services that address a vast array of problems impacting the health and function of a diverse patient population. The work requires the application of knowledge of therapeutic massage concepts, principles and practices, and encompasses a large variety of modalities from Western and Eastern traditions. Massage Therapy promotes circulation of blood and lymph, relieves muscle tension, and can induce a general relaxation response, alleviate pain and anxiety, promote sleep, reduce stress, and enhance the general sense of wellness. Employees in this occupation may utilize appropriate tools and the external applications of water, heat, and cold to enhance therapeutic benefits. Employees in this occupation incorporate knowledge of various systems of anatomy, physiology, and pathology to apply a plan of care for those with a variety of soft tissue dysfunctions, stress related conditions, and imbalances.

(1) Health Technician (Massage Therapy), GS-5 – Entry Level
(a) Education, Experience, and Licensure. None beyond the basic requirements in paragraph 3.
(NOTE: See exception to licensure/registration/certification requirement in subparagraph 3.c. above.)
(b) Assignment. Health Technician (Massage Therapy) at this level perform basic massage therapy services under close supervision. The technician functions independently in applying basic massage services. Basic massage therapy includes, but is not limited to effleurage (stroking), petrissage (kneading), tapotement/percussion, friction, vibration, passive and active stretching, and draping. The Health Technician (Massage Therapy) is responsible for changing linen between clients, refilling oils, cleaning massage table/chair/arm rest, and providing a clean, calm environment. The Health Technician (Massage Therapy) promotes and educates patients in the health and wellness benefits of massage, and develops therapeutic relationships with patient/family/significant others by demonstrating sensitivity and respect for a patient’s personal beliefs. Deviations from regular procedures, unanticipated problems, and unfamiliar situations are referred to the supervisor for a decision or assistance. Any unusual patient interactions are documented and immediately reported to the supervisor. Some assignments at this level include developmental duties involving more progressive care, designed to prepare the Health Technician (Massage Therapy) for promotion to higher grades. Such duties would be performed under close supervision.
(2) Health Technician (Massage Therapy), GS-6 – Developmental Level
(a) Education, Experience, and Licensure. In addition to the basic requirements, candidates must possess one year of experience equivalent to the GS-5 grade level, and demonstrate all the KSAs below:
(b) Demonstrated Knowledge, Skills, and Abilities
i. Skill to provide massage techniques including draping, using the appropriate tools, supplies, and equipment based on the needs of the patient;
ii. Knowledge of anatomy, physiology, pathology, therapeutic effects, and evidence based practice of massage therapy;
iii. Ability to work with an interdisciplinary team in a health care setting;
iv. Knowledge of all patient safety procedures, rules, and regulations as they pertain to a clinical environment; and
v. Ability to effectively communicate verbally/non-verbally and in writing (through a variety of modalities).
(c) Assignment. Employees at this grade level serve as developmental Health Technicians (Massage Therapy) and perform treatments which are routine and standardized in nature. The Health Technician (Massage Therapy) provides treatments in various inpatient and outpatient settings, in accordance with applicable policies and procedures. Health Technicians (Massage Therapy) perform a substantially full range of duties, but receive guidance and directions regarding unfamiliar or unusual situations for more complex patient issues.
(3) Health Technician (Massage Therapy) GS-7 – Full Performance Level
(a) Education, Experience, and Licensure. In addition to the basic requirements, candidates must possess one year of specialized experience equivalent to the GS-6 grade level performing massage therapy and demonstrate all the KSAs below:
(b) Demonstrated Knowledge, Skills, and Abilities
i. Ability to assess the physical and mental status of patients (including history and physical assessment), interpret the appropriate information to identify each patient’s population-specific needs, identify indications/contraindications for massage, develop the plan of care, and monitor their response to treatment;
ii. Ability to use various communication techniques to encourage and educate individuals and groups to enhance massage therapy outcomes;
iii. Skill in developing and maintaining strong interpersonal relationships; and
iv. Ability to advise staff and students in massage therapy practices.
(c) Assignment. At the full performance level, Health Technicians (Massage Therapy) independently assess the physical and mental status of patients. The Health Technician (Massage Therapy) takes complete patient history and performs a physical assessment. The Health Technician (Massage Therapy) interprets relevant clinical information to identify each patient’s population-specific needs, identify indications/contraindications for massage, and develop the plan of care. Health Technicians (Massage Therapy), at this level, are responsible to perform massage therapy services with complexity higher than the developmental level. The Health Technician (Massage Therapy) performs duties with limited supervision and seeks assistance from the supervisor in urgent or emergent circumstances. The Health Technician (Massage Therapy) evaluates patient responses to treatment and documents responses to treatment, by maintaining accurate records in an electronic environment. The Health Technician (Massage Therapy) coordinates follow up massage therapy as necessary. Health Technicians (Massage Therapy), at this level, serve as consultants to the health care team in the evaluation and treatment of the patient. Under routine academic oversight, the Health Technician (Massage Therapy) assists with clinical supervision of massage therapy students.
(4) Health Technician (Massage Therapy) GS-8 – Advanced Clinical Level
(a) Experience. In addition to meeting the basic requirements, candidates must possess one year of progressive experience equivalent to the GS-7 grade level. In addition, the candidate must demonstrate all the following KSAs:
(b) Demonstrated Knowledge, Skills, and Abilities
i. Skill in providing advanced massage techniques using the appropriate tools, supplies, and equipment based on the needs of the patient;
ii. Knowledge of anatomy, physiology, and pathology relevant to massage therapy within specialty population(s);
iii. Ability to modify massage therapy techniques based on an understanding of specialty populations, and various clinical/environmental settings;
iv. Knowledge of teaching methods and learning principles;
v. Ability to conduct research and quality improvement activities, related to massage therapy; and
vi. Knowledge of complementary integrative health, and holistic health principles.
(c) Assignment. For all assignments above the full performance level (GS-7), the higher-level duties must consist of significant scope, complexity (difficulty), variety, and be performed by the incumbent at least 25% of the time. At this level, the Health Technician (Massage Therapy) provides a full range of complex treatment procedures and modalities, which may include, but are not limited to reflexology, injury rehabilitation, lymphatic drainage, neuromuscular therapy, myofascial release, and/or craniosacral work. The Health Technician (Massage Therapy) is responsible to provide massage therapy services for specialty areas, such as pain management, poly-trauma, surgery, traumatic brain injury, palliative care, neurology, orthopedics, geriatrics, cardiology, pulmonary, rheumatology, spinal cord injury, mental health, and oncology. The Health Technician (Massage Therapy) assists other staff through education and as a member of an interdisciplinary health care team. The Health Technician (Massage Therapy) is a subject matter expert responsible for mentoring other Health Technicians (Massage Therapy) who participate in educational and research activities. The Health Technician (Massage Therapy) provides education in massage techniques to patients, caregivers, and employees. The Health Technician (Massage Therapy) contributes to identifying, collecting, and analyzing aggregate patient care information, to ensure safety and quality of care.
(5) Lead Health Technician (Massage Therapy), GS-8
(a) Experience. In addition to meeting the basic requirements, candidates must possess one year of progressively complex experience equivalent to the GS-7 grade level. In addition, the candidate must demonstrate all the following KSAs:
(b) Demonstrated Knowledge, Skills, and Abilities
i. Ability to delegate tasks and responsibilities;
ii. Ability to manage staffing requirements, workload priorities, and coordinate the work of the unit;
iii. Ability to provide staff development and training; and
iv. Ability to review and monitor data to ensure all records and reports are complete and accurate.
(c) Assignment. For all assignments above the full performance level, the higher-level duties must consist of significant scope, complexity (difficulty), variety, and be performed by the incumbent at least 25% of the time. The Lead Health Technician (Massage Therapy) monitors workload, provides input on performance, resolves daily workplace issues, and maintains efficient workflow. Assignments at this level include, but are not limited to: ensuring coverage of all areas of responsibility; conducting clinical reviews to assess the quality of work; providing input to staff that includes changes in policies and procedures; creating and maintaining employee work schedules; orienting and providing on-the-job training for new and current Health Technicians (Massage Therapy); and ensuring all training requirements are met. The Lead Health Technician (Massage Therapy) reviews and analyzes aggregate patient care data, to ensure safety and quality of care.
(6) Supervisory Health Technician (Massage Therapy), GS-9
(a) Experience. In addition to meeting the basic requirements, candidates must possess one year of progressively complex experience equivalent to the GS-8 grade level. In addition, the candidate must demonstrate all the following KSAs:
(b) Demonstrated Knowledge, Skills, and Abilities
i. Ability to provide the full range of administrative and supervisory duties which include, but are not limited to: assignment of work, performance evaluations, selection of staff, and recommendation of awards and/or advancements;
ii. Advanced knowledge of massage therapy across multiple areas of practice, and the demonstrated ability to provide guidance to staff massage therapists;
iii. Knowledge of how massage therapy integrates with other health care disciplines;
iv. Ability to assist in matters related to policy development, equipment requests, and workload analysis; and
v. Ability to delegate authority, evaluate and oversee people and programs, accomplish program goals, and adapt to changing priorities.
(c) Assignment. For all assignments above the full performance level, the higher-level duties must consist of significant scope, complexity (difficulty), variety, and be performed by the incumbent at least 25% of the time. The Supervisory Health Technician (Massage Therapy) is responsible for the supervision, administrative management, and direction of Health Technicians (Massage Therapy). The Supervisory Health Technician (Massage Therapy) has full administrative and professional responsibility for planning and directing the activities for the service or equivalent unit. Typical duties include: making work assignments, monitoring the staff’s clinical performance, conducting performance appraisals, and other clinical and administrative responsibilities, as assigned, to ensure that the mission of the service and the medical center has been satisfied. The Supervisory Health Technician (Massage Therapy) develops policies and procedures for the work unit, and contributes to the promotion of complementary and integrative health services. The Supervisory Health Technician (Massage Therapy) is responsible to review aggregate patient care data and take appropriate actions to ensure the safety and quality of care.

What does this mean for the future of the massage therapy profession?

Now that the VA has clearly defined standards of education and create a clear job description, many more may follow.

Will Medicare/Medicaid recognize massage therapy?

Will more health insurance companies recognize massage therapy?

Will more hospitals, hospice centers, cancer centers and rehab centers recognize massage therapy more and use the standards and job descriptions for their programs?

You betcha!

Follow this important thread for more info.

Google Business Listings is a business profile on Google that also gets you on Google Maps as well as search. With more people searching on maps these days, this can be very helpful in getting and keeping clients.

The thing about people finding you on Google is that people are searching for massage there which means they are looking for someone to give them massage. This is ideal to start with. You aren’t randomly looking for clients like you are when you are on a social media site.

Head over to Google Business.

Sign up or sign in. Check to see if your business is listed on Google.com/maps first. If it is, you can claim the business. If you already have claimed your business, you can login to Google Business. and make sure your profile is accurate and keep it up to date.

You can also maximize Google Business by adding photos of your office and store front and posting to your listing daily.

Join my Facebook Group to get help with your Google Business Listing and building your massage business.

As a massage therapist, there will always be people asking for a discount. We have become a discount economy. They may have found someone else charging half of what you are charging or they just want a discount. If people are asking you this just remember that you NEVER have to explain why you charge what you charge. Don’t take it personally when they ask.

People are used to getting discounts . Just because they ask you doesn’t mean they are bad people or are destined to be bad clients. It also doesn’t mean they’re challenging your value personally. You know you are taking it personally when you respond with something like the quote:

My Prices are based on my talents,

not your budget.

The problem is that this was actually found on a sign and other massage therapists were using it to promote themselves. This just is unprofessional. Claiming that your talents are worth more than anyone else’s is really not true. Telling clients that their budget may not be able to afford you is really shaming them for not having enough money or not budgeting enough for massage. You just don’t know why they were asking for a discount. Be curious and find out!

This isn’t the way to make a good impression. Your prices are not based only on your talents. Your prices should reflect your skills, trainings and time. They reflect how much you pay for rent and advertising. They are not really about YOUR value or how much you are worth. How much is a massage worth anyways? How much is it worth to be out of pain and have the weight of the world on your shoulders relieved? $70? $100? $1000?

The best way to handle this is to make sure your work speaks for itself and that also means your website, social media and other places where people find you.

The Best Way to Handle A request to reduce your prices.

Depending on the situation and if there is time to respond – start with asking the person why they are seeking a massage. Do they have something that they want to achieve or some goal they are working towards? Are they in pain or stress and need some relief from that?

When people are talking about money and prices, they are usually referring to something else. It isn’t really about the price point. They don’t yet trust you. They don’t know you. They don’t understand your value. They may have gotten a few lousy massages and paid too much for them at a high end spa or something like that. They do not know how you are different than all of the other massage therapists out there. These same people will shop at Nordstrom rather than Walmart, stay at 5 star hotels and drive a Mercedes or Lexus. It usually is NOT about the price. Find out what it is really about by asking questions about them.

• What are you getting massage for – some kind of pain/stress issue?
• What is that issue preventing you from doing – walking the dog, playing with kids/grandkids, sleeping, sitting at work, focusing….
• What things have you tried to help with that?
• Did massage help before?
• What did you like about your last massage (or not like)?

Get them talking. You will usually get to the reason why they want a discount. Then you can get to telling them why your massage is different and why they should try you. Focus on the outcomes of what you have seen. Focus on your expertise in the area without being egotistical about it.

You can’t do that with everyone of course. Some people will be more difficult. In that case you can just say something that won’t be offensive, but may get them talking in other ways.

• Oh that is interesting. I wonder how they make that work?
• Ask what do you get for that amount?
• Tell them that 30 minute sessions are available to try you out first before committing to an hour or 90 minute session.