Poised For An Insured Future 
While the massage community debates the need for a separate category of medical massage, a movement is already underway to position therapists to reap the insurance benefits of recognition as health-care providers.

The movement has momentum in the industry's national associations, education programs and in the only Department of Education-recognized certification board. And massage therapists are eager to get in on insurance benefits that can translate into rates as high as $150 per hour. Already 37 percent of American Massage Therapy Association (AMTA) members say they are involved with third-party reimbursement, mostly in the form of claims for workman's compensation and automobile accidents. But when it comes to massage therapists being recognized as health-care providers who can work on "medically necessary" conditions, some say change isn't happening fast enough.

In the past six months two new entities have emerged with alternative solutions to hasten the acceptance of massage therapists to work in the medical model. One new association claims it will provide massage therapists with the backing to effectively beat insurance-company resistance. The other portends a future tier of highly trained medical-massage specialists that will break through the glass ceiling imposed by insurance.

The American Medical Massage Therapy Association (AMMTA) debuted in 2003 to "defend medical massage therapists nationwide against unfair acts of discrimination, down coding, price fixing, delays and/or denials of payment" from insurance companies, according to its Web site. Founder and president David Luther says that insurers are still wary of massage therapists, and cite lack of uniform standards in training as the reason. The result is that acceptance of claims, payment and rates for medical-massage services are unreliable, he says.

Luther believes that it will take massage therapists sounding and acting like medical professionals to gain respect in the world of medical-insurance billing. "'Learn what physical therapists know that we should know' is our tag line," he says.

AMMTA membership dues are earmarked for a legal fund that will be used to pay for class-action lawsuits against carriers that discriminate against massage therapists. Other benefits of membership include free phone access to Luther's insurance-billing know-how, and practice insurance [which is offered through MASSAGE Magazine]. Meanwhile, members are encouraged to "improve" their skills, says Luther, through continuing education, including his 110-hour "master medical massage therapist" program.

Certification, however, is not a requirement of AMMTA membership, Luther says. There is no education requirement to join; members only need to show that they are actively billing insurance, says Luther.

Higher ed
Steve Miller also wants to see massage therapists established as health-care professionals capable of billing insurance - but unlike Luther, he believes that advanced education is the key to this acceptance.

Miller is founder of the International Center for Excellence in Massage Therapy (ICEMT), which offers a "diplomate" degree in massage therapy to qualified practitioners. The degree is the massage equivalent to the education standards required of physical therapists. The center is a credentialing institute, not an actual school. Its mission: "To provide the highest certification standards possible to ensure those practicing in the clinical field have completed a rigorous academic program and are committed to further development of the profession, medical care, and community service."

"Through my business dealings with physicians I hear over and over again that they'll work with massage therapists and that [the therapists] aren't very consistent," Miller says. On the other end of the spectrum, he says, insurance companies tell him they are concerned about the educational standards and skills of massage therapists.

"I would really like to see the notion that massage is a viable complementary [form of] care recognized by the insurance industry," he says.

To be eligible for certification through ICEMT, applicants must hold a bachelor's degree from an accredited university, and have received a grade of B or better in courses including anatomy, organic chemistry, research design and methodology, calculus and psychology, among others; have received 500 hours of massage-therapy education; and have had one year of professional experience and one year of civic involvement, including teaching or membership in a local chamber of commerce.

The ICEMT certification requirements are stringent, Miller says, because he believes that to be competent to do medical-based therapy - treatment based on physician prescription, in a set amount of sessions, with a specific goal in mind - requires solid understanding of focused treatment protocols.

"When I work with physicians, they need someone to release certain muscles, to assist someone in 15 minutes," he says.

Miller says he worked with medical professionals to model the certification after the diplomate program in physical therapy. "It has the massage-therapy training instead of the physical-therapy training," he says.

"If massage therapists would like to be reimbursed through the major medical carriers they [should have greater education in anatomy and physiology]," he adds.
- Kelle Walsh

More Table Talk                                                            See May/June 2004 Issue