Navigating Healthcare Partnerships as an LMT
Partnering with a healthcare plan as a licensed massage therapist (LMT) can feel overwhelming. Historically, healthcare payment structures weren’t built with massage therapists in mind, leaving us without proper guidance. It’s not that we can’t integrate—it’s that no one showed us how. Health plan partnerships often failed us, creating paperwork burdens that are impossible for a solo massage therapist to manage while still focusing on healing their clients. Many of us, right out of school, do not find ourselves profiting in medical settings and look to other modalities as a way to earn money faster. When we want to take the next step past cash-based to medical work, we often find ourselves placed second to chiropractors, physical therapists, or other barriers to success.
Addressing Systemic Barriers 🚧
Educational Gaps 🎓
It’s not just one factor that makes it difficult to maintain a sustainable practice as a solo massage therapy practitioner. We’re expected to juggle medical billing, scheduling, and compliance—roles beyond our core skill set. Our training programs, which are mandatory for state licensure, do not include learning the end-to-end processes necessary to be a sustainable massage healthcare practitioner. Some state boards further complicate things by absorbing LMTs under cosmetology or chiropractic boards, creating confusion.
Arizona Barriers 🌵
A recent development with the Arizona State (AZ) Board of Massage Therapy made the news earlier this month due to a system upgrade. While the website upgrade is appreciated by those who use the system, once again, broken processes and lack of communication threw many Arizona LMTs into an unneeded state of anxiety and financial loss. This created chaos, and rumors the board may in fact be breaking apart. The Arizona government had to intervene. An audit on the AZ massage board revealed delayed complaint investigations, lack of transparency, and inadequate responses to public inquiries. While the board has made progress on some recommendations, challenges persist in fully addressing these concerns. 🕵️♀️
Other State Barriers 🗺️
This situation begs the question: What is going on in our national state regulatory massage boards? Why is the solution often, to completely eliminate a board, rather than use the funds we paid for licensure and continuing education credits to overhaul the entire outdated board to be more capable and robust in meeting the needs of the LMTs who seek to practice in that state? The mixed messages, 1. insurance health plans in critical need of LMTs with National Provider Numbers (NPIs), and 2. the lack of seriousness for our profession on part of the state massage boards. Many state massage board operate due to volunteer help to process LMT license annually. States push us away due to broken government processes keeping a program a flot, while for profit healthcare industry (insurance plans) seeks our services to accomplish 1. lowering their improve their bottom lines annually and 2. reduce drug use in America. The lack of awareness, motivation and/or funding at the state level in some pockets of America is extremely polarizing. 🔄
Below we provide a summary of specific state regulations for continuing education units (CEU) requirements, annual mandated educational classes for massage therapy, and that these do not require CEUs at all, which is a direct fall out of dismantling the massage board in a state, further creating unclear paths for massage therapists who desire to take the next step in their healthcare journey. The result of the boards being eliminated is not necessarily just due to the controversially conversation on if continuing education is actually needed for career success. The suspension of certain boards could be due to broader systemic changes or budgetary reasons rather than the direct reversal of CEU policies.
- Ohio: Does not require continuing education for license renewal. The Ohio State Medical Board oversees massage therapy regulation.
- Michigan: Does not require continuing education for license renewal. The Michigan Department of Licensing and Regulatory Affairs (LARA) manages massage therapy licensure.
- Maine: Does not require continuing education for license renewal. The Maine Department of Professional and Financial Regulation oversees massage therapy.
- Kansas: Does not have finalized legislation regarding continuing education requirements. The Kansas Board of Cosmetology regulates massage therapy.
- Utah: Does not require continuing education for license renewal. The Utah Division of Occupational and Professional Licensing manages massage therapy licensure.
- Vermont: Does not have a state-level massage therapy board, and regulation is handled at the local level.
- Oklahoma: Does not have finalized legislation regarding continuing education requirements. The Oklahoma State Department of Health oversees massage therapy.
Overcoming Barriers 🔥
One of the biggest challenges our profession faces is perception. Despite years of advocacy, we still struggle to be recognized in healthcare settings. That’s no surprise—bad actors continuously drag our industry through the mud, to the point where massage establishment licenses in many states are issued through the police department rather than the health department. In non-therapeutic spaces, a coworker recently admitted to me they didn’t even realize LMTs require formal education and licensure.
Research Supporting Massage Therapy
AMTA Invests $2.5 Million in Massage Therapy Research
The American Massage Therapy Association (AMTA) recently announced a $2.5 million investment over the next five years to fund research through the Massage Therapy Foundation (MTF). This funding, the largest in MTF’s history, ensures the advancement of high-quality scientific research, education, and community service to strengthen the profession. “The deepening of MTF’s partnership with AMTA positions us to amplify our vision and strengthen our impact on the massage profession now and in the future,” said Adrienne Asta, MTF President.
VA Health Research Supporting Massage Therapy
The Veterans Affairs (VA) Health Research Center has conducted extensive studies on massage therapy’s role in reducing opioid prescriptions for chronic pain. Studies show massage therapy for veterans experiencing chronic pain can lead to decreased pain levels, increased mobility, and a reduction in opioid use among veterans. In fact, veterans engaged in the VA's Whole Health approach fostered by the VA Community Care Network program (VA-CCN) benefit from complementary therapies like massage. Veterans experienced a 38% reduction in opioid use, compared to an 11% decrease among those not utilizing Whole Health services.
Policy Shifts Supporting LMTs
The Path Forward
Since 2018, policy has shifted to create easier working relationships between LMTs and health plans. Two major drivers—the 2018 Bipartisan Budget Act and the 2018 MISSION Act—have expanded opportunities for LMTs through strategic partnerships. One key product of the MISSION Act is the VA-CCN.
The truth is, LMTs can successfully partner with health plans. Jody and I already have been successful in Pima County, Arizona, supporting Veterans through the VA-CCN program. We took our first referral for therapeutic massage services to treat Veteran medical pain diagnosis through the VA-CCN in May 2024.
By the end of 2024, we had been referred and had served over 130 Veterans in Pima County, all while I worked as his virtual assistant while he did the treatments. We were able to meet his need working in a small space and having the administration completley in the cloud. This year we are expanding and rebranding into Level Up Medical Massage and plan to grow with the need in our county, moving out of a cash-based business to primarily insurance reimbursements as our source of income.
🆔 The National Provider Identifier (NPI)
The NPI is a unique 10-digit ID for healthcare providers in the U.S., streamlining electronic transactions. Below are some facts about next steps for those who want to learn more.
📜 Background of the NPI
Before the NPI, different health plans used various identifiers, causing confusion. Established by Health Insurance Portability and Accountability Act (HIPAA) in 1996, NPIs became operational in 2007.
🏛 Who Manages NPIs?
Managed by National Plan and Provider Enumeration System (NPPES) under Center for Medicare Services (CMS), NPIs remain with providers for life, regardless of changes.
🌟 Spotlight: CHAQ Credentialing
Credentialing verifies provider qualifications, ensuring compliance with healthcare standards.
📌 Perspective: Third-Party Administrators (TPAs)
TPAs manage networks, claims, and credentialing, improving provider access and efficiency. Learn more about TPAs.
Tucson Solutions 🌵
Level Up Medical Massage aims to be a trusted community partner for LMT's who desire to become grounded in the healthcare sector. Jody and I launch our new clinic March 1, 2025 in East Tucson. In the middle of the mixed messages and deregulation of some state massage boards, there are simple paths to secure sustainiable income as a massage therapist. For some of us, it seems as if gaining an NPI credential along with your LMT license may a good way to remain relevant in this profession, as paths forward become more unstable and confusing.
