Setting Massage Rates

Setting rates for massage is just like setting rates for any professional service. You consider a number of personal, business, and ethical factors and then set your rates based on your professional judgement.

  • Personal factors include how much money you want to make, how many hours you want to work, how many years you can (or want to) work, where you want to work, etc.
  • Business factors include market considerations like competitors’ rates and consumer demand for the service you offer, financial considerations like the costs you incur in delivering your service and how much you need to earn to cover your rent, operational considerations like the amount of time it takes to deliver the service, etc.
  • Ethical factors include treating all of your customers fairly, maintaining accessibility to the service you offer, abiding by professional codes of ethics, etc.

Different Rates for Different Services

It is common and accepted business practice to charge different rates for different services. Few massage therapists charge the same hourly rate for office wellness massage, for outcall wellness massage, and for on-site chair massage. Different services, different rates. Another massage service is medical massage. See my page on the differences between medical massage and wellness massage for an enumeration of the differences between this service and office wellness massage.

Discounting

It is also common and accepted business practice to offer discounts for business services. For an office wellness visit, a massage therapist might offer a $10-off first-time discount, or they might offer sliding-scale rates for low-income customers, or they might offer a discount for a bundle of pre-paid massages. For their outcall service, they might offer $20 off the second massage given at the same site during the same visit. For their on-site chair massage, they might offer a discount on their regular hourly rate for a long-term contract. For their medical massage services, they might agree to offer a discount to a health care organization in exchange for access to the organization’s members.

Putting these considerations together, a massage practitioner (a very ambitious one who wants to offer four different services), might end up with a table like this to inform their rate-setting process:

Medical Massage and Wellness Massage

 

Type of Massage

Office Wellness

Outcall Wellness

On-Site

Medical

where to get competitors’ rate information

phone offices and clinics, competitors’ promotional materials, etc.

hotel concierges, competitors’ promotional materials, etc.

human resources department heads, competitors’ promotional materials, etc.

National Fee Analyzer, competitors’ promotional materials, etc.

financial costs of delivering the service

supplies, equipment (fixed table), office rent, etc.

supplies, equipment (portable table), gas, oil, car maintenance, etc.

supplies, equipment (portable chair), gas, oil, car maintenance, etc.

supplies (more detailed forms), equipment (refrigerator, hydrocollator, table, etc.), medical reference books, billing service, etc.

amount of time it takes to deliver the service

table time plus a couple of minutes for documentation

driving time, set-up time, table time, documentation time

driving time, set-up time, table time, documentation time

evaluation and assessment time, table time, documentation time, communication time (correspondence, reports, etc.)

how to make the service accessible

get office in convenient location; offer sliding-scale fees

expand geographical coverage area

expand geographical coverage area

join managed-care networks and PPOS; set rate low enough to maximize care received under typical PIP claim

discounting rationale

“If I give them the first one at a discount, they’ll see how good I am and come back for full-price visits.”
or
“If they’ll pay me up front for 5 massages, I’ll give them X% off since I’ll have their money in the bank and have assurance they’ll come back.”

“Since I’m already at your home (and have already incurred my travel costs), I’ll give you a discount for two massages on the same visit.”

“If you’ll agree to have me come to your office once a week, I’ll give you a deal to lock in the business.”
or
“If you get a 20-minute chair massage I will charge you less than twice what I charge for a 10-minute massage since I’ve already incurred the marketing and operational costs of getting you in my chair.”

“I’ll agree to a discounted reimbursement rate from your PPO to get the chance to offer my services to you (but I’ll always put my regular medical massage rate on the HCFA form to remind the payer of what a good deal they’re getting).”

 

Office Wellness

Outcall Wellness

On-Site

Medical

If you are a massage therapist in the process of setting your rates, make a table like the one above and do the homework to create and fill in all the relevant rows and columns. This example is by no means complete, so you’ll want to add your own rows for the personal, business, and ethical considerations that are important to you and your own columns for the services you offer. Once you’ve done this exercise, your rate structure will probably jump right out at you.

Common Objections to Pricing Differentials for Massage Services

Some common objections come up in discussions of how to set massage prices. Here are my thoughts on a few of these.

You can’t charge more for medical massage when you’re using the same techniques as in your wellness practice.

Someone who washes windows on the upper floors of a skyscraper charges more than another washer who does ground-level residential windows. They’re both using the same techniques and supplies, but the guy hanging from the skyscraper has taken on a few more risks and responsibilities, and the prices he charges reflects this.

Similarly, when massage therapists start dealing with additional risks and responsibilities, their rates go up. When a massage therapist drives across town and lugs their table to a client’s home or hotel room, they typically charge 50% to 100% more for their outcall service than for the same wellness massage delivered in their office. Likewise, when massage therapists start doing medical massage – working under a doctor’s prescription and taking on all of the attendant risks (late or non- payment, clinical risks, etc.) and responsibilities (to insurance companies, other health care providers, lawyers, courts, etc.) – they can charge more for their services. How much more? That’s for each practitioner to decide – see the discussion above.

OK, maybe you can charge a little bit more for medical massage to cover the billing costs you incur, but only XX% more.

This position assumes that the only additional costs one incurs by delivering medical massage are billing costs. As the table above shows, there are many other costs (both tangible, like the amount of time one spends on paperwork, and intangible, like the amount of legal and financial risk one takes on) associated with delivering medical massage services.

Furthermore, this argument undercuts the perfectly valid use of usual, customer, and reasonable pricing information found in the National Fee Analyzer and similar publications. It is just as legitimate to base medical massage fees on what others in your area are charging as it is to base them on the costs you incur in delivering the service. As I point out above, any prudent and thorough professional will evaluate both these data and many other factors when deciding on their rate schedule.

When it comes to medical massage and the nationally published reimbursement data, we lowly massage therapists don’t dare charge as much for 97124 and 97140 as those highly trained physical therapists, chiropractors, and naturopaths.

Yes, massage therapists have less overall training than other health care providers (and it behooves us to be realistic and modest about where we fit in the medical system), but when the subject is billing for CPT codes 97124 or 97140, we are talking about delivering massage services – that’s all. Regardless of how much other training someone has in anatomy and physiology, pathologies, diagnosis, treatment modalities, etc., anyone appropriately trained in delivering a massage CPT code should be able to charge the usual, customary, and reasonable rates for that service in their geographical area.

I don’t know exactly how much massage training other health care practitioners who deliver 97124 and 97140 get. A few quick web searches of health care practitioner curricula and anecdotal evidence tell me it’s typically less than one would get in a 500-hour massage certification course. So you could just as easily turn this argument around and say, “How dare these under-massage-trained practitioners charge as much for these medical massage services as we highly trained massage professionals.”

Price Fixing Concerns

One other subject that frequently arises when I talk with other massage therapists about how to set massage prices is concern about price fixing. I am not an attorney and this is not legal advice, but as I understand it (from conversations with attorneys), it is not illegal to tell another practitioner how much you charge for a service (and, after all, they could just call your office or pick up your brochure to find out anyway); however, if you start to collude with other massage businesses and agree on how much to charge then you’re definitely on shaky legal ground. If you have any legal concerns about setting your massage rates, consult an attorney.


Footnote on Experience and Training

One would hope that experience and training would figure into the rate-setting process, but in my experience it is more market forces that drive pricing, at least when it comes to wellness massage (looming developments in medical massage may mean that massage therapists will have to have more training and experience to bill insurance companies, but that’s not the case yet). Consumers get it in their head that a massage costs $XX in their town, and so anyone, regardless of their ability, training, and experience can charge that much. When you are setting your prices, this falls under the “ethical considerations” umbrella – are you really worth how much you are charging for a massage?


Keywords: massage price, massage prices, massage pricing, massage rates, rate, fee, fees, charge, charges, cost, costs.

This page created 6/18/04; last updated 1/05/06.